| NPI | 1346732781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology Dermatopathology (Licence: ND 19688) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MO 2018017656) |
| 207ND0900X Dermatology Dermatopathology (Licence: ND PT19688) | |
| Enumeration Date | 2018-06-01 |
| Last Update Date | 2025-02-21 |