| 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) |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2021-01-11 |