NPI | 1124061619 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WI 74455-20) |
Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WA MD00034088) |
207ZD0900X Pathology, Dermatopathology (Licence: WI 74455-20) | |
207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME122758) | |
207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OR MD21809) | |
207ND0900X Dermatology, Dermatopathology (Licence: WI 74455-20) | |
Enumeration Date | 2006-06-13 |
Last Update Date | 2023-02-13 |