| NPI | 1366658437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: GA 061056) |
| Additional Taxonomies | 207ZD0900X Pathology Dermatopathology (Licence: GA 061056) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2015-05-29 |