| NPI | 1902647951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: MI 5151016630) |
| Additional Taxonomies | 207ZN0500X Pathology, Neuropathology (Licence: MI 5151016630) |
| Enumeration Date | 2024-06-04 |
| Last Update Date | 2024-06-04 |