| NPI | 1972551828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 269591) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: PA MD444339) |
| 207ZH0000X Pathology, Hematology (Licence: NY 269591) | |
| 207ZH0000X Pathology, Hematology (Licence: NJ MA090167) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CT 56204) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2020-08-10 |