| NPI | 1750002465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZN0500X Pathology, Neuropathology (Licence: UT 14235906-1205) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MN 32870) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MN 74855) | |
| Enumeration Date | 2022-09-09 |
| Last Update Date | 2025-08-28 |