| NPI | 1851773782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NJ 25MA10869700) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MD467000) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MT208849) | |
| Enumeration Date | 2015-06-27 |
| Last Update Date | 2020-07-23 |