| NPI | 1750788485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 277737) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NJ 25MB09933300) |
| 207ZF0201X Pathology, Forensic Pathology (Licence: NJ 25MB09933300) | |
| Enumeration Date | 2014-11-24 |
| Last Update Date | 2024-05-02 |