NPI | 1508854902 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MD043392L) |
Additional Taxonomies | 207N00000X Dermatology (Licence: PA MD043392L) |
Enumeration Date | 2005-10-10 |
Last Update Date | 2014-04-30 |