| NPI | 1073682514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: FL TRN6801) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: FL TRN6801) |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: FL TRN6801) | |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2007-07-08 |