| NPI | 1053392365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZN0500X Pathology Neuropathology (Licence: CT 040897) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: CT 040897) |
| 207ZP0101X Pathology Anatomic Pathology (Licence: CA A72353) | |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2007-07-08 |