| NPI | 1639516891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NJ 25MA09738600) |
| Additional Taxonomies | 207ZP0007X Pathology, Molecular Genetic Pathology (Licence: NJ 25MA09738600) |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: NJ 25MA09738600) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MA L-255276) | |
| Enumeration Date | 2013-05-29 |
| Last Update Date | 2024-10-30 |