| NPI | 1811335896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX S2394) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: CA A147797) |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2020-05-08 |