| NPI | 1639112337 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NJ 25MA07523100) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: NJ 25MA07523100) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2011-11-23 |