| NPI | 1164405510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NJ 25MA07206100) |
| Additional Taxonomies | 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: NJ 25MA07206100) |
| 207ZC0500X Pathology, Cytopathology (Licence: NJ 25MA07206100) | |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2007-08-03 |