| NPI | 1730140245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: WI 31718) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: WI 31718) |
| 207Y00000X Otolaryngology (Licence: WI 31718) | |
| Enumeration Date | 2006-04-01 |
| Last Update Date | 2025-08-14 |