| NPI | 1124293972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZC0500X Pathology, Cytopathology (Licence: NC 2012-00362) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NC 2012-00362) | |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2013-07-19 |