| NPI | 1043285620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: SC 21725) |
| Additional Taxonomies | 207ZD0900X Pathology Dermatopathology (Licence: SC 21725) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2018-04-09 |