| NPI | 1912226812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: TX Q8860) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX Q8860) |
| Enumeration Date | 2010-05-18 |
| Last Update Date | 2017-01-24 |