| NPI | 1053995563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZH0000X Pathology, Hematology (Licence: OH 35.153558) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: IL 125.078052) | |
| Enumeration Date | 2021-05-11 |
| Last Update Date | 2025-10-13 |