| NPI | 1609370097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: NJ 25MA11389200) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: NY 207ZD0900X) |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: NH 38590) | |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2026-01-15 |