| NPI | 1558532515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WA MD60018719) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: WA MD60018719) |
| 207ND0900X Dermatology, Dermatopathology (Licence: WA MD60018719) | |
| Enumeration Date | 2008-03-18 |
| Last Update Date | 2008-07-31 |