| NPI | 1558378968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: CO 06D0931182) |
| Additional Taxonomies | 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: VA 0101041485) |
| 207ZD0900X Pathology, Dermatopathology (Licence: CO 30709) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: VA 0101041485) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2020-08-26 |