| NPI | 1801946447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: CA C54257) |
| Additional Taxonomies | 207ZN0500X Pathology, Neuropathology (Licence: CA C54257) |
| 174400000X Specialist (Licence: PA MD067543L) | |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2010-08-10 |