| NPI | 1568647006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: FL ME124512) |
| Additional Taxonomies | 207ZN0500X Pathology, Neuropathology (Licence: FL ME124512) |
| 207ZP0213X Pathology, Pediatric Pathology (Licence: FL ME124512) | |
| Enumeration Date | 2008-01-03 |
| Last Update Date | 2023-05-23 |