| NPI | 1235626771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: OK 41800) |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2024-10-07 |