| NPI | 1851376305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZD0900X Pathology Dermatopathology (Licence: AZ 25050) |
| Additional Taxonomies | 207ND0900X Dermatology Dermatopathology (Licence: MN 36212) |
| 207ND0900X Dermatology Dermatopathology (Licence: AZ 25050) | |
| 207ND0900X Dermatology Dermatopathology (Licence: UT 176536-1205) | |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2014-09-09 |