| NPI | 1669421145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MI 4301074949) |
| Additional Taxonomies | 207ND0900X Dermatology Dermatopathology (Licence: MI 4301074949) |
| 207ZP0007X Pathology Molecular Genetic Pathology (Licence: MI 4301074949) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2023-06-28 |