| NPI | 1073512265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX G4960) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: TX G4960) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2026-05-06 |