| NPI | 1922180801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology Dermatopathology (Licence: MI 4301060359) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MI 4301060359) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CA G84418) | |
| 207ZD0900X Pathology Dermatopathology (Licence: CA G84418) | |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2008-05-27 |