| NPI | 1962884288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WI 70552-20) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AZ R74987) |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2021-09-20 |