| NPI | 1245765015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZC0006X Pathology, Clinical Pathology (Licence: GA 89383) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MS 800971896) |
| Enumeration Date | 2017-04-28 |
| Last Update Date | 2023-05-29 |