| NPI | 1700863685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: WI 36968) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: WI 36968) |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2015-05-01 |