| NPI | 1124235437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CT 043041) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: NY 235123) |
| 207ZD0900X Pathology, Dermatopathology (Licence: CT 043041) | |
| 207ZD0900X Pathology, Dermatopathology (Licence: NC 2003-01008) | |
| 207ZD0900X Pathology, Dermatopathology (Licence: VA 0101-235450) | |
| 207ZD0900X Pathology, Dermatopathology (Licence: CA A79347) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2017-10-13 |