| NPI | 1558340323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology Dermatopathology (Licence: FL ME75437) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: FL ME75437) |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2008-07-31 |