| NPI | 1649652520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZN0500X Pathology, Neuropathology (Licence: MO 2023029274) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: KY R3776) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: KY 04482) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MO 2023029274) | |
| Enumeration Date | 2015-06-26 |
| Last Update Date | 2023-07-25 |