| NPI | 1871538124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: MI 4301065083) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA C43108) |
| 207ZD0900X Pathology, Dermatopathology (Licence: CA C43108) | |
| 207ZD0900X Pathology, Dermatopathology (Licence: AZ 36275) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA C43108) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MI 4301065083) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AZ 36275) | |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2016-01-26 |