| NPI | 1881734028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: WI 46411-020) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WI 46411-020) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2007-07-08 |