| NPI | 1598757155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NY 152043) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: NY 152043) |
| 207ZN0500X Pathology Neuropathology (Licence: NY 152043) | |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2019-11-20 |