| NPI | 1275788705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MI 4301112003) |
| Additional Taxonomies | 207ZC0006X Pathology, Clinical Pathology (Licence: FL ME107392) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10023529) | |
| Enumeration Date | 2008-11-25 |
| Last Update Date | 2018-11-08 |