| 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 |