| NPI | 1598042970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZF0201X Pathology, Forensic Pathology (Licence: NJ 25MA05945200) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PA MD049601L) |
| Enumeration Date | 2011-11-13 |
| Last Update Date | 2016-10-11 |