| NPI | 1154647188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TN 50564) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: TN 50564) |
| Enumeration Date | 2010-04-15 |
| Last Update Date | 2018-03-17 |