| NPI | 1194159202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZC0006X Pathology, Clinical Pathology (Licence: MA 273824) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 255307) |
| Enumeration Date | 2013-08-26 |
| Last Update Date | 2018-05-16 |