| NPI | 1558403311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology Anatomic Pathology (Licence: MA 222785) |
| Additional Taxonomies | 207ND0900X Dermatology Dermatopathology (Licence: CT 047989) |
| 207ZD0900X Pathology Dermatopathology (Licence: CT 047989) | |
| 207ZP0101X Pathology Anatomic Pathology (Licence: CT 047989) | |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2023-06-30 |