| NPI | 1306230503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WI 70404-20) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: WI 70404-20) |
| 207ZD0900X Pathology, Dermatopathology (Licence: WI 70404-20) | |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2025-08-29 |