| NPI | 1457351793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZN0500X Pathology Neuropathology (Licence: WA MD0002609) |
| Additional Taxonomies | 207ZN0500X Pathology Neuropathology (Licence: NJ 25MA07966400) |
| 207ZN0500X Pathology Neuropathology (Licence: VA 101030965) | |
| 207ZN0500X Pathology Neuropathology (Licence: NY 143531) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: WA MD0002609) | |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2010-06-25 |