| NPI | 1477544534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 225214) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MA 285755) |
| 207ZD0900X Pathology, Dermatopathology (Licence: MA 285755) | |
| Enumeration Date | 2005-10-28 |
| Last Update Date | 2021-02-18 |