| NPI | 1912906546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NY 211831) |
| Additional Taxonomies | 207ZC0500X Pathology Cytopathology (Licence: NY 211831) |
| 2083X0100X Preventive Medicine Occupational Medicine (Licence: NY 211831) | |
| Enumeration Date | 2005-07-15 |
| Last Update Date | 2019-12-20 |