| NPI | 1114365533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207ZN0500X Pathology Neuropathology (Licence: NE 28398) |
| Enumeration Date | 2013-06-07 |
| Last Update Date | 2019-06-10 |