| NPI | 1205414117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 246RH0600X Technician, Pathology, Histology |
| 156F00000X Technician/Technologist | |
| Enumeration Date | 2021-03-31 |
| Last Update Date | 2026-03-31 |