| NPI | 1114939964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: FL ME99450) |
| Additional Taxonomies | 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: NV 10837) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NV 10837) | |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2010-07-01 |