| NPI | 1003867946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology Dermatopathology (Licence: MI 4301074152) |
| Additional Taxonomies | 207ZC0006X Pathology Clinical Pathology (Licence: MI 4301074152) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2024-01-23 |