| NPI | 1487081998 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207ZF0201X Pathology, Forensic Pathology (Licence: CT 034498) | 
| Additional Taxonomies | 207ZF0201X Pathology, Forensic Pathology (Licence: NY 206274) | 
| Enumeration Date | 2013-09-28 | 
| Last Update Date | 2022-12-02 |