| NPI | 1124394572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: CO DR.0070540) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: VA 101269055) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: VA 101269055) | |
| 208200000X Plastic Surgery (Licence: CA A127813) | |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2023-08-08 |