| NPI | 1235758442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology Anatomic Pathology (Licence: TN 73131) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: AL L.5579R) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: AL L.5579R) | |
| Enumeration Date | 2020-04-09 |
| Last Update Date | 2025-06-11 |