| NPI | 1679796544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: LA MD 025469) |
| Additional Taxonomies | 207ZN0500X Pathology, Neuropathology (Licence: TX N1391) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2024-06-04 |