| NPI | 1871536243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: ID M-8883) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: ID M8883) |
| 246Q00000X Spec/Tech, Pathology (Licence: ID M8883) | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2020-11-12 |