| NPI | 1265811426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: FL ME152127) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: IL 036.150753) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 63673) | |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2021-09-02 |