| NPI | 1629036470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207ZN0500X Pathology Neuropathology (Licence: CA G59408) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CA G59408) |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2007-07-09 |