| NPI | 1053739227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NE 1155) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: NE 1155) |
| 207ND0900X Dermatology, Dermatopathology (Licence: MT 101370) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MT 101370) | |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2024-04-08 |