| NPI | 1659468346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: NY 127571) |
| Additional Taxonomies | 207ZC0500X Pathology Cytopathology (Licence: NY 127571) |
| 207ZC0500X Pathology Cytopathology (Licence: MO R5974) | |
| 207ZC0500X Pathology Cytopathology (Licence: OH 35041398) | |
| 207ZP0101X Pathology Anatomic Pathology (Licence: NY 127571) | |
| 207ZP0101X Pathology Anatomic Pathology (Licence: MO R5974) | |
| 207ZP0101X Pathology Anatomic Pathology (Licence: OH 35041398) | |
| 207ZP0213X Pathology Pediatric Pathology (Licence: NY 127571) | |
| 207ZP0213X Pathology Pediatric Pathology (Licence: MO R5974) | |
| 207ZP0213X Pathology Pediatric Pathology (Licence: OH 35041398) | |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2012-05-15 |