| NPI | 1639325483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZC0006X Pathology, Clinical Pathology (Licence: NJ 25MA08450200) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NJ 25MA08450200) |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2008-08-19 |