| NPI | 1376784421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL OS13393) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: TX M6814) |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: TX M6814) | |
| 207ZD0900X Pathology, Dermatopathology (Licence: FL OS13393) | |
| Enumeration Date | 2009-03-19 |
| Last Update Date | 2017-01-10 |