| NPI | 1003121310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NY 279497) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207ZH0000X Pathology Hematology (Licence: NY 279497) | |
| 207ZP0007X Pathology Molecular Genetic Pathology (Licence: NY 279497) | |
| Enumeration Date | 2010-08-11 |
| Last Update Date | 2017-04-14 |