| NPI | 1174503502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: TX M0681) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: AZ 28744) |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2014-04-24 |