| NPI | 1750521019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZC0006X Pathology, Clinical Pathology (Licence: NY 256263) |
| Additional Taxonomies | 207ZC0006X Pathology, Clinical Pathology (Licence: MA 215016) |
| Enumeration Date | 2009-02-26 |
| Last Update Date | 2012-08-29 |