| NPI | 1295085686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: GA 73740) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 268124) | |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2023-08-10 |