| NPI | 1639312697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology Dermatopathology (Licence: TX R3924) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: TX R3924) |
| 207ZD0900X Pathology Dermatopathology (Licence: SC DO82995) | |
| 207ZH0000X Pathology Hematology (Licence: AL DO.1421) | |
| 207ZP0007X Pathology Molecular Genetic Pathology (Licence: OK 5304) | |
| Enumeration Date | 2009-04-07 |
| Last Update Date | 2023-12-31 |