| NPI | 1538696455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: ID M-16213) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: FL ME157824) |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2025-09-25 |