| NPI | 1063899623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZM0300X Pathology, Medical Microbiology (Licence: TN 65207) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2022-06-16 |