| NPI | 1649639022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZN0500X Pathology, Neuropathology (Licence: PR 19628) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: PR 19628) |
| Enumeration Date | 2016-02-15 |
| Last Update Date | 2024-08-21 |