| NPI | 1700104973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZN0500X Pathology, Neuropathology (Licence: MD D0080950) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: MD 4248) |
| Enumeration Date | 2010-05-12 |
| Last Update Date | 2016-05-18 |