| NPI | 1174519607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: CA A65484) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: NY 221206) |
| 207ZD0900X Pathology, Dermatopathology (Licence: NY 221206) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA A65484) | |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2018-07-11 |