| NPI | 1629746227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: FL ME178947) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: FL ME178947) |
| Enumeration Date | 2021-08-31 |
| Last Update Date | 2026-02-09 |