| NPI | 1073075032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: WI 2955-321) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: WI 2955-321) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WI 2955-321) | |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2024-07-22 |