| NPI | 1295710754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: GA 048594) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: FL OS8431) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL OS8431) | |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2009-02-04 |