| NPI | 1811967904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NJ 25MB07201700) |
| Additional Taxonomies | 207ZC0500X Pathology Cytopathology (Licence: NJ 25MB07201700) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2014-09-26 |