| NPI | 1205982162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZC0500X Pathology, Cytopathology (Licence: NJ 25MA08423500) |
| Additional Taxonomies | 207ZC0006X Pathology, Clinical Pathology (Licence: NJ 25MA08423500) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MT187988) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NJ 25MA08423500) | |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2021-06-02 |