| NPI | 1699865188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZN0500X Pathology, Neuropathology (Licence: WA MD61021293) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: WA MD61021293) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2020-05-19 |