| NPI | 1679573570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NC 2019-02897) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: NY 195978) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2024-03-13 |