| NPI | 1528089349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: GA 064454) |
| Additional Taxonomies | 207ZN0500X Pathology Neuropathology (Licence: SC 84997) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2020-10-01 |