| NPI | 1831180827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: OH 35-04-8777) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OH 35048777) |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2010-08-11 |