| NPI | 1982667143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: VA 0101237470) |
| Additional Taxonomies | 246Q00000X Spec/Tech, Pathology (Licence: MD D0062528) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2022-03-23 |