| NPI | 1750672119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: NJ 25MA10147800) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: NY 319797-01) |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: CT 73264) | |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: PA MD453827) | |
| Enumeration Date | 2011-04-20 |
| Last Update Date | 2025-02-24 |