| NPI | 1215955950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: TX H5867) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX H5867) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2015-03-23 |