| NPI | 1124254933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA C159083) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: CA C159083) |
| Enumeration Date | 2009-06-08 |
| Last Update Date | 2019-01-19 |