| NPI | 1124004924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: PA MD-020491-E) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MD020491E) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2016-02-24 |