| NPI | 1376033563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: MN 79808) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: WI 85806-20) |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2025-12-04 |