| NPI | 1376518829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology Dermatopathology (Licence: MT 102048) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MT 102048) |
| Enumeration Date | 2006-02-20 |
| Last Update Date | 2024-04-08 |