| NPI | 1245239425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: TX L5809) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: TX L5809) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2017-02-28 |