| NPI | 1740240787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PR 15384) |
| Additional Taxonomies | 207ZN0500X Pathology, Neuropathology (Licence: PR 15384) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2016-12-21 |