| NPI | 1194709717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology Dermatopathology (Licence: FL ME66090) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: FL ME66090) |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2018-03-17 |