| NPI | 1750488607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology Dermatopathology (Licence: CA G67769) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CA G67769) |
| 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: CA G67769) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2016-05-27 |