| NPI | 1972885010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZN0500X Pathology, Neuropathology (Licence: CT 60303) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MA L-247485) |
| Enumeration Date | 2011-09-14 |
| Last Update Date | 2018-05-01 |