| NPI | 1639192974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: NJ 25MA03110800) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: NJ 25MA03110800) |
| 207N00000X Dermatology (Licence: NJ 25MA03110800) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2012-06-11 |