| NPI | 1952300717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZC0500X Pathology, Cytopathology (Licence: NY 145302) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: NY 145302) |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2011-12-28 |