| NPI | 1932209129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: WI 46678-020) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: WI 46678-20) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WI 46678) | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2023-03-08 |