| NPI | 1972901882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 221712) |
| Additional Taxonomies | 207ZF0201X Pathology, Forensic Pathology (Licence: NY 221712) |
| Enumeration Date | 2014-12-09 |
| Last Update Date | 2023-02-01 |