| NPI | 1134944622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 246RM2200X Technician, Pathology, Medical Laboratory |
| Enumeration Date | 2024-11-19 |
| Last Update Date | 2024-11-19 |