| NPI | 1588667380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: GA 055069) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: GA 055069) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AL 00026165) | |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2008-09-10 |