| NPI | 1154451243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: CA G88468) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: MA 57846) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2011-04-05 |