| NPI | 1710956123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: MI 4301079403) |
| Additional Taxonomies | 207ZC0006X Pathology, Clinical Pathology (Licence: MI 4301079403) |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: MI 4301079403) | |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2024-01-23 |