| NPI | 1336665322 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZF0201X Pathology, Forensic Pathology (Licence: GA 058738)  | 
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: GA 058738)  | 
| Enumeration Date | 2017-08-21 | 
| Last Update Date | 2022-07-21 |