| NPI | 1720014897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME58150) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: FL ME58150) |
| 207ZC0006X Pathology, Clinical Pathology (Licence: FL ME58150) | |
| 207ZD0900X Pathology, Dermatopathology (Licence: FL ME58150) | |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: FL ME58150) | |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2022-09-01 |