| NPI | 1972183317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZN0500X Pathology, Neuropathology (Licence: CA A184053) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: CA A184053) |
| Enumeration Date | 2021-04-09 |
| Last Update Date | 2025-06-12 |