| NPI | 1851720262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: MA 258728) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: MA 258728) |
| Enumeration Date | 2013-11-06 |
| Last Update Date | 2014-08-12 |