NPI | 1902870892 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: CA 20A9298) |
Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA 20A9298) |
Enumeration Date | 2006-02-15 |
Last Update Date | 2019-10-15 |