| NPI | 1801865910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: FL ME110100) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CO 42589) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2025-01-03 |