| NPI | 1871630350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: GA 83381) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: FL ME88066) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MA 234394) | |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2024-04-17 |