| NPI | 1437130804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX N0551) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: TX N0551) |
| 207ZD0900X Pathology, Dermatopathology (Licence: CA 20A16487) | |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2020-10-20 |