| NPI | 1205095346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology Anatomic Pathology (Licence: AL MD36102) |
| Additional Taxonomies | 207ZC0500X Pathology Cytopathology (Licence: FL ME125027) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: FL ME125027) | |
| 207ZD0900X Pathology Dermatopathology (Licence: FL ME125027) | |
| 207ZD0900X Pathology Dermatopathology (Licence: AL MD.36102) | |
| Enumeration Date | 2008-06-04 |
| Last Update Date | 2021-05-06 |