| NPI | 1346732781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MO 2018017656) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: ND PT19688) |
| Enumeration Date | 2018-06-01 |
| Last Update Date | 2023-07-18 |