| NPI | 1184940256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZN0500X Pathology, Neuropathology (Licence: CA C175791) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: CA C175791) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-04-14 |
| Last Update Date | 2022-05-19 |