| NPI | 1831178318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: NY 173191-1) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: NY 173191-1) |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2020-10-29 |