NPI | 1043368723 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: LA 023755) |
Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: LA 023755) |
Enumeration Date | 2007-01-08 |
Last Update Date | 2012-06-15 |