| NPI | 1598741563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NC 26801) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NC 009000253) |
| 207ZD0900X Pathology, Dermatopathology (Licence: NC 009000253) | |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2020-10-25 |