| NPI | 1952383432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WA MD00039332) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: WA MD00039332) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2010-04-15 |