| NPI | 1992782791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: PA MD024051E) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OH MD024051E) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2008-06-09 |