| NPI | 1578739736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: MN 106078) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MI 4301091881) |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2012-10-09 |