| NPI | 1508248782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 305274) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: CA A146753) |
| 207ZD0900X Pathology, Dermatopathology (Licence: CT 66241) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CT 66241) | |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2025-01-29 |