| NPI | 1104346063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology Dermatopathology (Licence: CA A197591) |
| Additional Taxonomies | 207ZD0900X Pathology Dermatopathology (Licence: PA MD469474) |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2024-09-23 |