| NPI | 1588709620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology Anatomic Pathology (Licence: AR E-6071) |
| Additional Taxonomies | 207ZD0900X Pathology Dermatopathology (Licence: AR E-6071) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2013-09-18 |