| NPI | 1548410525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: NY 259866) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: NY 259866) |
| Enumeration Date | 2008-09-25 |
| Last Update Date | 2025-01-31 |