| NPI | 1083817548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: TX N5892) |
| Additional Taxonomies | 207ZD0900X Pathology Dermatopathology (Licence: FL ME101586) |
| 207ZD0900X Pathology Dermatopathology (Licence: TX N5892) | |
| 207ZD0900X Pathology Dermatopathology (Licence: CA A109789) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: FL ME101586) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CA A109789) | |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2020-04-06 |