| NPI | 1174530612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA G27926) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: CA G27926) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AZ 7644) | |
| 207ZD0900X Pathology, Dermatopathology (Licence: AZ 7644) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2008-06-20 |