NPI | 1700844099 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: NE 21483) |
Additional Taxonomies | 207N00000X Dermatology (Licence: NE 21483) |
Enumeration Date | 2006-05-03 |
Last Update Date | 2011-06-24 |