| NPI | 1780893719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: SC 39099) |
| Additional Taxonomies | 207ZD0900X Pathology Dermatopathology (Licence: SC 39099) |
| 207ZD0900X Pathology Dermatopathology (Licence: NC 2014-01451) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2021-11-08 |