| NPI | 1306067517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: NJ 25MA08751700) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: NY 257875) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2026-04-07 |