| NPI | 1811124548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: MD D88004) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: PA MD446749) |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: PA MD446749) | |
| Enumeration Date | 2009-06-20 |
| Last Update Date | 2019-08-01 |