| NPI | 1649209735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: NY 134434) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 134434) |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2008-03-04 |