| NPI | 1427031046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MN 49303) |
| Additional Taxonomies | 207ZD0900X Pathology Dermatopathology (Licence: MA 48925) |
| 207ZP0101X Pathology Anatomic Pathology (Licence: MA 48925) | |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2020-10-06 |