| NPI | 1720239072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: NY 314109) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: NH 16550) |
| 207ZD0900X Pathology, Dermatopathology (Licence: NH 16550) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 314109) | |
| Enumeration Date | 2008-10-06 |
| Last Update Date | 2022-06-15 |