| NPI | 1285936187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MD005676E) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: PA MD005676E) |
| Enumeration Date | 2010-11-27 |
| Last Update Date | 2010-11-27 |