| NPI | 1972572881 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: OK 22783) | 
| Additional Taxonomies | 207ZN0500X Pathology, Neuropathology (Licence: OK 22783) | 
| Enumeration Date | 2006-03-14 | 
| Last Update Date | 2017-01-23 |