| NPI | 1902066582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MD450941) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: PA MD450941) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: UT 6851331-1205) | |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2020-08-06 |