| NPI | 1922526391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OR MD223968) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: OR MD223968) |
| 207ZD0900X Pathology, Dermatopathology (Licence: CA A179113) | |
| 207ZD0900X Pathology, Dermatopathology (Licence: WA MD61419846) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA A179113) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WA MD61419846) | |
| Enumeration Date | 2017-09-06 |
| Last Update Date | 2025-03-12 |