| NPI | 1235572819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207ZP0007X Pathology, Molecular Genetic Pathology (Licence: CA A161641) |
| 207ZP0007X Pathology, Molecular Genetic Pathology (Licence: NY 287540) | |
| Enumeration Date | 2013-04-12 |
| Last Update Date | 2020-11-03 |