| NPI | 1639139215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: KY 22701) |
| Additional Taxonomies | 207ZN0500X Pathology, Neuropathology (Licence: KY 22701) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2020-03-13 |