| NPI | 1851553523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: SC 38654) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: NC 212471) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MA 237599) | |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2026-01-26 |