| NPI | 1992781785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: PA MD425122) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: WV 20246) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MD425122) | |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2024-01-03 |