| NPI | 1720071459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: MD D62986) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: NY 225049) |
| Enumeration Date | 2005-08-29 |
| Last Update Date | 2013-01-05 |