| NPI | 1710985650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZN0500X Pathology Neuropathology (Licence: NY 220453) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: NY 220453) |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2009-04-26 |