| NPI | 1548622533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology Dermatopathology (Licence: WI 1675-321) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: WI 1675-321) |
| 207ZD0900X Pathology Dermatopathology (Licence: WI 1675-321) | |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2022-07-26 |