| NPI | 1194229989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: PA OS022011) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NJ 25IB13195400) |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2026-08-06 |