| NPI | 1710909189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OK 10338) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: OK 10338) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: KS 04-28881) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NC 21990) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2018-07-03 |