| NPI | 1902330855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: NY 3483533) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: NY 3483533) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA A145783) | |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2026-02-02 |