| 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 |