| NPI | 1831140862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MD064790L) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NJ 25MA07172200) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2013-08-27 |