| NPI | 1457307209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology Anatomic Pathology (Licence: TX G6375) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX G6375) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2024-04-22 |