NPI | 1174889091 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: MI 4301109024) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2012-04-04 |
Last Update Date | 2016-08-11 |