| NPI | 1750540613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX P0622) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MD D71270) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 242403-1) | |
| 207ZD0900X Pathology, Dermatopathology (Licence: NY 242403) | |
| 207ZD0900X Pathology, Dermatopathology (Licence: MD D71270) | |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2020-11-10 |