| NPI | 1205095155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: NJ 25MB08969500) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 248863-1) |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: NJ 25MB08969500) | |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2026-02-16 |