| NPI | 1285698423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: WA MD00025624) |
| Additional Taxonomies | 207ZN0500X Pathology Neuropathology (Licence: WA MD00025624) |
| 207ZP0101X Pathology Anatomic Pathology (Licence: WA MD00025624) | |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2022-05-11 |