| NPI | 1023177870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ND0900X Dermatology Dermatopathology (Licence: CA 00A192080) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: CA 00A192080) |
| 207N00000X Dermatology (Licence: CA 00A192080) | |
| 207NP0225X Dermatology Pediatric Dermatology (Licence: CA 00A192080) | |
| 207NS0135X Dermatology Procedural Dermatology (Licence: CA 00A192080) | |
| 207ZD0900X Pathology Dermatopathology (Licence: CA 00A192080) | |
| 207ZI0100X Pathology Immunopathology (Licence: CA 00A192080) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CA 00A192080) | |
| 207ZP0213X Pathology Pediatric Pathology (Licence: CA 00A192080) | |
| 208D00000X General Practice (Licence: CA 00A192080) | |
| 209800000X Legal Medicine (Licence: CA 00A192080) | |
| Enumeration Date | 2006-12-07 |
| Last Update Date | 2008-05-20 |