| NPI | 1386714525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology Dermatopathology (Licence: RI MD13530) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: MA 233573) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2011-02-10 |