| NPI | 1962559021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NE 22171) |
| Additional Taxonomies | 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: NE 22171) |
| 207ZN0500X Pathology, Neuropathology (Licence: NE 22171) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2025-05-23 |