| NPI | 1215298187 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: RI MD14908)  | 
| Additional Taxonomies | 207ZN0500X Pathology, Neuropathology (Licence: RI MD14908)  | 
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NE 29344)  | |
| Enumeration Date | 2012-06-06 | 
| Last Update Date | 2022-01-17 |