| NPI | 1265450738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: MO 30743) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: MO 30743) |
| 207ZP0213X Pathology, Pediatric Pathology (Licence: MO 30743) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2024-04-25 |