| NPI | 1194789271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: TN 15614) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: VA 0101281191) |
| 207ZD0900X Pathology, Dermatopathology (Licence: GA 68780) | |
| 207ZD0900X Pathology, Dermatopathology (Licence: VT 042.0010674) | |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: VA 0101281191) | |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2026-05-11 |