| NPI | 1134108673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology Dermatopathology (Licence: NY 109386-1) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 109386-1) |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2008-06-09 |