| NPI | 1235314188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NE 27230) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: IA 41216) |
| 207ZD0900X Pathology Dermatopathology (Licence: NE 27230) | |
| 207ZD0900X Pathology Dermatopathology (Licence: IA 41216) | |
| Enumeration Date | 2008-01-09 |
| Last Update Date | 2017-02-06 |