| NPI | 1063435808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology Dermatopathology (Licence: TX M1198) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: TX M1198) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2015-09-30 |