| NPI | 1073598512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: IA MD-37037) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: IA MD-37037) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2023-11-20 |