| NPI | 1770727430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: SC 85574) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME135040) |
| 207ZN0500X Pathology, Neuropathology (Licence: SC 85574) | |
| Enumeration Date | 2009-04-26 |
| Last Update Date | 2021-11-08 |