| NPI | 1982790218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: NY 203832) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NY 203832) |
| 207R00000X Internal Medicine (Licence: NY 203832) | |
| 207ZP0101X Pathology Anatomic Pathology (Licence: NY 203832) | |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2020-04-07 |