| NPI | 1043411168 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: UT 5558245-1205) | 
| Additional Taxonomies | 207N00000X Dermatology (Licence: MN 50181) | 
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: UT 5558245-1205) | |
| 207ZP0104X Pathology, Chemical Pathology (Licence: UT 5558245-1205) | |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: MN 103224) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-05-29 | 
| Last Update Date | 2023-05-26 |