| NPI | 1891876454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: NJ MA74633) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: PA MD030137E) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2007-07-08 |