| NPI | 1730258708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MO 2005005716) |
| Additional Taxonomies | 207ZD0900X Pathology Dermatopathology (Licence: MO 2005005716) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2017-05-04 |