| NPI | 1538135900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: PA MD061425L) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: PA MD061425L) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MD061425L) | |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2007-12-07 |