| NPI | 1477628584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology Dermatopathology (Licence: FL ME87050) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: FL ME87050) |
| 207ZC0500X Pathology Cytopathology (Licence: FL ME87050) | |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2020-03-23 |