| NPI | 1396704649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: FL ME64349) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME64349) |
| 207ZD0900X Pathology, Dermatopathology (Licence: FL ME64349) | |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2022-11-18 |