| NPI | 1699712919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: OH 35087741) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OH 35087741) |
| 207ZD0900X Pathology, Dermatopathology (Licence: WA md00040145) | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2020-12-18 |