NPI | 1063493377 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: CT 033679) |
Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CT 033679) |
Enumeration Date | 2005-11-14 |
Last Update Date | 2007-07-08 |