| NPI | 1124351747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: NJ 25MA08646700) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: MI 4301085118) |
| 207ZD0900X Pathology, Dermatopathology (Licence: OH 35.092241) | |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: NJ 25MA08646700) | |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: MI 4301085118) | |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: OH 35.092241) | |
| Enumeration Date | 2009-09-14 |
| Last Update Date | 2019-08-30 |