| NPI | 1083699540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: FL ME34650) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME34650) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2015-04-23 |