| NPI | 1730398181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX S4277) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NE 24098) |
| 207ZN0500X Pathology, Neuropathology (Licence: NE 24098) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2025-07-03 |