| NPI | 1194189480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX S3036) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX BP10056540) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX S3036) | |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2022-05-09 |