| NPI | 1790079218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NJ 25MA09957300) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: NJ 25MA09957300) |
| 207ZH0000X Pathology, Hematology (Licence: PA MD437788) | |
| 207ZH0000X Pathology, Hematology (Licence: NJ 25MA09957300) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA C173873) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 282313) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MD437788) | |
| Enumeration Date | 2011-06-01 |
| Last Update Date | 2024-04-10 |