| NPI | 1700884665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: IA 45874) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: NY 228325) |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: NM MD2017-0967) | |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2020-10-13 |