| NPI | 1669449161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: SC 35527) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MD033258E) |
| 207ZD0900X Pathology, Dermatopathology (Licence: PA MD033258E) | |
| 207ZD0900X Pathology, Dermatopathology (Licence: NY 260871) | |
| 207N00000X Dermatology (Licence: NY 260871) | |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2015-04-08 |