| NPI | 1093906422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: LA MD.205661) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: GA 069148) |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2013-01-24 |