| NPI | 1548432180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: FL ME111001) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: TX temp) |
| Enumeration Date | 2008-03-24 |
| Last Update Date | 2023-03-23 |