| NPI | 1306233796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: KS 04-43350) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: PA MD469116) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MN 67178) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-23 |
| Last Update Date | 2021-12-27 |