| NPI | 1003893827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology Anatomic Pathology (Licence: KY 38910) |
| Additional Taxonomies | 207ZF0201X Pathology Forensic Pathology (Licence: KY 38910) |
| 207ZN0500X Pathology Neuropathology (Licence: KY 38910) | |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2009-07-15 |