| NPI | 1447250501 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NJ 25MA05982200) | 
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: NJ 25MA05982200) | 
| 207ZI0100X Pathology, Immunopathology (Licence: NJ 25MA05982200) | |
| Enumeration Date | 2005-07-29 | 
| Last Update Date | 2007-10-23 |