| NPI | 1720304298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX T4227) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: TX T4227) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: IL 036.132976) | |
| Enumeration Date | 2010-04-08 |
| Last Update Date | 2023-05-05 |