| NPI | 1760780837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: NJ 25MA10804300) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MT198369) |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: PA MD450984) | |
| Enumeration Date | 2011-03-14 |
| Last Update Date | 2020-08-11 |