| NPI | 1871616581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CT 65306) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NJ 25MA08927100) |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2020-08-25 |