| NPI | 1407802572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207ZD0900X Pathology Dermatopathology (Licence: MD D0021961) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MD D0021961) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2023-03-07 |