| NPI | 1346409216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology Anatomic Pathology (Licence: NY 248334-1) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NY 248334-1) |
| 207ZN0500X Pathology Neuropathology (Licence: NY 248334-1) | |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2014-09-18 |