| NPI | 1255310785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CO DR32152) |
| Additional Taxonomies | 207ND0900X Dermatology Dermatopathology (Licence: CO DR32152) |
| 207ZH0000X Pathology Hematology (Licence: CO DR32152) | |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2021-05-11 |