| NPI | 1285028605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX V1310) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NC 2021-01392) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2024-07-01 |