| NPI | 1811052855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: WA MD60131035) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: WA MD60131035) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2023-01-10 |