| NPI | 1053582353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: GA 052870) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: VA 0101032713) |
| 207ZD0900X Pathology, Dermatopathology (Licence: AL 00023737) | |
| 207ZD0900X Pathology, Dermatopathology (Licence: SC 26892) | |
| 207ZD0900X Pathology, Dermatopathology (Licence: NC 200400265) | |
| 207ZD0900X Pathology, Dermatopathology (Licence: PA MD247781) | |
| 207ZD0900X Pathology, Dermatopathology (Licence: FL ME98759) | |
| 207ZD0900X Pathology, Dermatopathology (Licence: GA 052870) | |
| Enumeration Date | 2008-03-14 |
| Last Update Date | 2015-09-25 |