| NPI | 1962466565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: TN MD0000037428) |
| Additional Taxonomies | 207ZD0900X Pathology Dermatopathology (Licence: TN 37428) |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2024-11-22 |