| NPI | 1295794949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: TX R1612) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: VA 0101055348) |
| 207ZD0900X Pathology, Dermatopathology (Licence: CA A85691) | |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2017-04-27 |