| NPI | 1003867946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: MN 81674) |
| Additional Taxonomies | 207ZC0006X Pathology, Clinical Pathology (Licence: MI 4301074152) |
| 207ZD0900X Pathology, Dermatopathology (Licence: MI 4301074152) | |
| 207ZD0900X Pathology, Dermatopathology (Licence: WI 87015-20) | |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2026-03-18 |