| NPI | 1376698126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AR E-5986) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: NY 247278) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 247278) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME111337) | |
| 207ZD0900X Pathology, Dermatopathology (Licence: FL ME111337) | |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2011-11-17 |