| NPI | 1013112739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NJ 25MA06810700) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: NJ 25MA06810700) |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2025-09-11 |