| NPI | 1023005261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: OH 350460580) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OH 350460580) |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2016-01-30 |