| NPI | 1104245554 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NJ 25MA11492000) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 305712) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: GA 88187) | |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2025-01-23 |