| NPI | 1902124126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NJ 25MA09670600) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MI 4301091902) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NY 264774) | |
| Enumeration Date | 2010-05-12 |
| Last Update Date | 2022-05-20 |