| NPI | 1336580471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: AL DO.2666) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: SD 16528) |
| 207ZD0900X Pathology, Dermatopathology (Licence: ND 16528) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA 20A 12293) | |
| Enumeration Date | 2013-07-16 |
| Last Update Date | 2024-04-17 |