| NPI | 1336183920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: PA MD441708) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ 25MA03479600) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2011-05-02 |