| NPI | 1609080845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: VA 0101277589) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME98509) |
| 207ZD0900X Pathology, Dermatopathology (Licence: FL ME98509) | |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2023-12-28 |