| NPI | 1164492898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology Dermatopathology (Licence: FL ME57238) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: FL ME57238) |
| 207ZC0500X Pathology Cytopathology (Licence: FL ME57238) | |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2017-02-15 |