| NPI | 1811031370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: MD D0066609) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: NY 252924) |
| Enumeration Date | 2007-02-17 |
| Last Update Date | 2015-04-06 |