| NPI | 1598145120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CT 76290) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: NY 309266-01) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 309266-01) | |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2023-12-28 |