| NPI | 1053305771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX E0372) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: TX E0372) |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2007-07-08 |