| NPI | 1952550311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: MI 4301091972) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: MI 4301091972) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MI 4301091972) | |
| Enumeration Date | 2008-09-10 |
| Last Update Date | 2019-12-03 |