| NPI | 1720107816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: MI 4301101033) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: MI 4301001033) |
| 207ZD0900X Pathology, Dermatopathology (Licence: NC 2006-00866) | |
| 207ZD0900X Pathology, Dermatopathology (Licence: GA 57854) | |
| 207ZD0900X Pathology, Dermatopathology (Licence: SC 29128) | |
| 207ZD0900X Pathology, Dermatopathology (Licence: CA A77438) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MI 4301001033) | |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2022-04-08 |