| NPI | 1538301973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology Dermatopathology (Licence: MN 557781) |
| Additional Taxonomies | 207ZD0900X Pathology Dermatopathology (Licence: IA MD41691) |
| 207ZD0900X Pathology Dermatopathology (Licence: OR MD161051) | |
| Enumeration Date | 2009-03-31 |
| Last Update Date | 2021-07-16 |