| NPI | 1083816136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: FL ME111481) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301096457) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2019-01-17 |