| NPI | 1881917433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: LA MD.202714) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: LA MD.202714) |
| 208D00000X General Practice (Licence: LA MD.202714) | |
| Enumeration Date | 2010-03-10 |
| Last Update Date | 2016-03-03 |