| NPI | 1902963119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA G143507) |
| Additional Taxonomies | 207ZN0500X Pathology, Neuropathology (Licence: CA G143507) |
| 207ZN0500X Pathology, Neuropathology (Licence: WA MD00041243) | |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: CA G143507) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WA MD00041243) | |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2024-03-14 |