| NPI | 1831393438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: TX M7084) |
| Additional Taxonomies | 207ZD0900X Pathology Dermatopathology (Licence: WV 33120) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: WV 33120) | |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2024-08-20 |