| NPI | 1790779528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: MO 2007035962) |
| Additional Taxonomies | 207ZN0500X Pathology, Neuropathology (Licence: NY 170281) |
| 207ZN0500X Pathology, Neuropathology (Licence: CO DR.0072814) | |
| 207ZN0500X Pathology, Neuropathology (Licence: MO 2007035962) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CO DR.0072814) | |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2025-10-14 |