| NPI | 1609193069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology Anatomic Pathology (Licence: NJ 25MA10489500) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: DC MD04625) |
| Enumeration Date | 2010-04-26 |
| Last Update Date | 2024-10-25 |