| NPI | 1215907001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: SC 13175) |
| Additional Taxonomies | 174400000X Specialist (Licence: SC 13175) |
| 174400000X Specialist (Licence: CA G42540) | |
| 174400000X Specialist (Licence: NY 139248-1) | |
| 174400000X Specialist (Licence: NC 26287) | |
| 174400000X Specialist (Licence: AZ 13206) | |
| 174400000X Specialist (Licence: LA MD014949) | |
| 174400000X Specialist (Licence: TX G0452) | |
| 174400000X Specialist (Licence: SC AK2281905) | |
| 207ND0900X Dermatology, Dermatopathology (Licence: SC 13175) | |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2013-08-07 |