| NPI | 1245693456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0007X Pathology, Molecular Genetic Pathology (Licence: MA 288278) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2023-08-01 |