| NPI | 1871524710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology Dermatopathology (Licence: MD D62132) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MD D62132) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2018-03-17 |