| NPI | 1407828684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: MI 4301512285) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME93737) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: IN 01065084A) | |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2024-10-15 |