| NPI | 1174810774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology Anatomic Pathology (Licence: WA MD60540645) |
| Additional Taxonomies | 207ZN0500X Pathology Neuropathology (Licence: WA MD60540645) |
| Enumeration Date | 2011-07-01 |
| Last Update Date | 2015-07-09 |