| 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 |