| NPI | 1164527800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX E8980) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: TX E8980) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2013-08-15 |