| NPI | 1639146129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 103573) |
| Additional Taxonomies | 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: NY 103573) |
| 207ZC0500X Pathology, Cytopathology (Licence: NY 103573) | |
| 207ZD0900X Pathology, Dermatopathology (Licence: NY 103573) | |
| 207ZH0000X Pathology, Hematology (Licence: NY 103573) | |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2008-04-10 |