| NPI | 1033351044 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: MI 4301093821) | 
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: MI 4301093821) | 
| Enumeration Date | 2009-04-06 | 
| Last Update Date | 2020-10-08 |