| NPI | 1932347440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NJ 25MA08321600) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NY 244058) |
| Enumeration Date | 2009-01-22 |
| Last Update Date | 2016-04-05 |