| NPI | 1548244692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: AZ 44849) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WI 33153-020) |
| 207ZD0900X Pathology, Dermatopathology (Licence: WI 33153-020) | |
| 207ZD0900X Pathology, Dermatopathology (Licence: AZ 44849) | |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2021-01-08 |