| NPI | 1578603767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME99158) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: FL ME99158) |
| 207ZH0000X Pathology, Hematology (Licence: NJ 25MA0816-8000) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NJ 25MA0816-8000) | |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2011-02-17 |