| NPI | 1528393733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZF0201X Pathology, Forensic Pathology (Licence: NJ 25MA06024500) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MD051000L) |
| Enumeration Date | 2009-10-05 |
| Last Update Date | 2009-10-05 |