| NPI | 1598951303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: TN 43644) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TN 43644) |
| 207ZD0900X Pathology, Dermatopathology (Licence: TX M5670) | |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: TN 43644) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX M5670) | |
| Enumeration Date | 2007-09-15 |
| Last Update Date | 2023-11-20 |