| NPI | 1043665409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: GA 89644) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: GA 89644) |
| 207ZH0000X Pathology, Hematology (Licence: AL MD.42925) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AL MD.42925) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2022-06-29 |