| NPI | 1841272820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME74422) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: FL ME84422) |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2007-12-10 |