| NPI | 1619049780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology Anatomic Pathology (Licence: NJ 25MA08156100) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NY 232559) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2024-02-12 |