NPI | 1407263924 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207ZN0500X Pathology, Neuropathology (Licence: WI 72669-20) |
Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MA 260190) |
2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: WI 72669-20) | |
Enumeration Date | 2014-07-16 |
Last Update Date | 2021-01-25 |