| NPI | 1194112581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZF0201X Pathology, Forensic Pathology (Licence: NE 32760) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OH 35.136417) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: SD 221) | |
| Enumeration Date | 2015-04-23 |
| Last Update Date | 2021-08-31 |