| NPI | 1124287198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology Dermatopathology (Licence: NC 2011-01185) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NY 240416) |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2022-12-15 |