| NPI | 1376519249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: WA MD00032449) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: CA G68841) |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: ID M-11701) | |
| 207ZD0900X Pathology, Dermatopathology (Licence: ID M-11701) | |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: AK 7969) | |
| 207ZD0900X Pathology, Dermatopathology (Licence: AK 7969) | |
| 207ZD0900X Pathology, Dermatopathology (Licence: MT MEDPHYSLIC26143) | |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: MT MEDPHYSLIC26143) | |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: CA G68841) | |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2025-09-19 |