| NPI | 1114130408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology Dermatopathology (Licence: AL MD.25042) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: AL MD.25042) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2021-06-09 |