| NPI | 1285889402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NM MD2014-0867) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2012-0353) |
| Enumeration Date | 2008-12-02 |
| Last Update Date | 2016-09-12 |