| NPI | 1336289578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA06980700) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: NJ 25MA06980700) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NJ 25MA06980700) | |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2007-07-08 |