| NPI | 1124435011 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZN0500X Pathology, Neuropathology (Licence: MN 59520)  | 
| Additional Taxonomies | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: MN 59520)  | 
| Enumeration Date | 2014-07-13 | 
| Last Update Date | 2019-01-16 |