| NPI | 1043294754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NJ 25MA07564500) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MD050567L) |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2021-08-20 |