| NPI | 1023540556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: OH 35.142674) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: OH 35142674) |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2024-04-16 |