| NPI | 1902048887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: NY 266160) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 266160) |
| Enumeration Date | 2009-03-24 |
| Last Update Date | 2020-04-03 |