| NPI | 1356811939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA OS021302) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NJ 25MB10821900) |
| Enumeration Date | 2018-11-27 |
| Last Update Date | 2021-06-23 |