| NPI | 1245691781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207ZN0500X Pathology, Neuropathology (Licence: CA 5322) |
| Enumeration Date | 2016-03-11 |
| Last Update Date | 2023-03-05 |