| NPI | 1750587127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: FL ME139625) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CT 50693) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NY 259638) | |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2019-05-16 |