| NPI | 1083874978 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WA MD61532902)  | 
| Additional Taxonomies | 207ZN0500X Pathology, Neuropathology (Licence: ID 7461370)  | 
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AK 226337)  | |
| 207ZN0500X Pathology, Neuropathology (Licence: MT MEDPHYSLIC142204)  | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 249260)  | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: ID 7461370)  | |
| 207ZN0500X Pathology, Neuropathology (Licence: WA MD61532902)  | |
| 207ZN0500X Pathology, Neuropathology (Licence: AK 226337)  | |
| 207ZN0500X Pathology, Neuropathology (Licence: NY 249260)  | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MT MEDPHYSLIC142204)  | |
| Enumeration Date | 2008-06-13 | 
| Last Update Date | 2025-09-19 |