| NPI | 1245230911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NJ MA02512500) |
| Additional Taxonomies | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: NJ 25MA02512500) |
| 171100000X Acupuncturist (Licence: NJ P-0008) | |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2009-01-07 |