| NPI | 1568813863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MO 2021011092) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: MO 2021011092) |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2024-04-25 |