| NPI | 1184601122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: WI 23892) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: WI 23892) |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2015-05-01 |