| NPI | 1568608651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA TMD004672) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: AR E7425) |
| 207ZD0900X Pathology, Dermatopathology (Licence: TX N5684) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AR E7425) | |
| Enumeration Date | 2008-12-20 |
| Last Update Date | 2020-05-28 |