ILHAM DERHAN PUTRA

NEW YORK, NY
NPI1770110389
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology
(Licence: NY  337333-01)
Enumeration Date2020-03-24
Last Update Date2026-06-25
Business Address
ILHAM DERHAN PUTRA
525 E 68TH ST
NEW YORK, NY 10065-4870
Phone number: 813-789-3508
Mailing Address
ILHAM DERHAN PUTRA
525 E 68TH ST
NEW YORK, NY 10065-4870
Phone number:
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