| NPI | 1972587004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: FL ME94720) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: DE C1-0007055) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2015-05-08 |