| NPI | 1396122727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AZ 58790) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: AZ 58790) |
| Enumeration Date | 2015-05-06 |
| Last Update Date | 2023-03-20 |