| NPI | 1801807656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: NY 215411-1) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: NY 215411) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2023-07-05 |