NPI | 1104156033 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NM 74-29) |
Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: NM 74-29) |
Enumeration Date | 2009-12-24 |
Last Update Date | 2009-12-24 |