| NPI | 1669406088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NY 247217) |
| Additional Taxonomies | 207ZC0500X Pathology Cytopathology (Licence: PA MD425765) |
| 207ZC0500X Pathology Cytopathology (Licence: NY 247217) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: PA MD425765) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2019-07-30 |