| NPI | 1548367402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: CA A56061) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: CA A56061) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA A56061) | |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: CA A56061) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2019-09-26 |