| NPI | 1093993263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA A109927) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX M6122) |
| 207ZD0900X Pathology, Dermatopathology (Licence: TX M6122) | |
| 207ND0900X Dermatology, Dermatopathology (Licence: CA A109927) | |
| Enumeration Date | 2008-02-09 |
| Last Update Date | 2016-09-02 |