| NPI | 1326076019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: CA G59803) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: CA G59803) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA G59803) | |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2018-03-17 |