| NPI | 1902984438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: NY 271175) |
| Additional Taxonomies | 207ZN0500X Pathology, Neuropathology (Licence: NY 271175) |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: WI 54513 - 020) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2019-01-17 |