| NPI | 1063493625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: CA G28999) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: CA G28999) |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2012-04-05 |