| NPI | 1013168830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: UT 7471512-1205) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2008030582) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX BP10044759) | |
| Enumeration Date | 2008-10-10 |
| Last Update Date | 2013-10-04 |