| NPI | 1184667289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NJ 25MA03121400) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ 25MA03121400) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2011-01-04 |