| NPI | 1174782353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX P2668) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: TX P2668) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: LA 206777) | |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2018-02-21 |