| NPI | 1356567044 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: IL 036.111130) | 
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: PA OS014665) | 
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA OS014665) | |
| Enumeration Date | 2007-04-18 | 
| Last Update Date | 2012-08-13 |