| NPI | 1508240342 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: TX V1632) | 
| Additional Taxonomies | 207ZN0500X Pathology, Neuropathology (Licence: TX V1632) | 
| 207ZP0101X Pathology, Anatomic Pathology (Licence: MA 263811) | |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: MA 277735) | |
| Enumeration Date | 2015-07-10 | 
| Last Update Date | 2024-11-15 |