| NPI | 1689899817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: NY 314193) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: NY 314193) |
| Enumeration Date | 2007-04-14 |
| Last Update Date | 2023-05-30 |