| NPI | 1871582023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CO DR.0055860) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: OR MD214761) |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2026-04-22 |