| NPI | 1568468270 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: AL 11242)  | 
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: FL ME93129)  | 
| 207ZD0900X Pathology, Dermatopathology (Licence: GA 056703)  | |
| 207ZD0900X Pathology, Dermatopathology (Licence: NC 2005-01455)  | |
| 207ZD0900X Pathology, Dermatopathology (Licence: TN 41316)  | |
| 207ZD0900X Pathology, Dermatopathology (Licence: SC 31214)  | |
| 207ZD0900X Pathology, Dermatopathology (Licence: VA 0101244538)  | |
| Enumeration Date | 2005-06-27 | 
| Last Update Date | 2013-10-01 |