| NPI | 1811078892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: NY 258425) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NJ 25MA08774800) |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: MI 4301061893) | |
| 208800000X Urology (Licence: NJ 25MA08774800) | |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2022-07-18 |