| NPI | 1144857087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: MA 1017409) |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2024-02-28 |