| NPI | 1316259195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MS 25995) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: VA 0101260308) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2010016113) | |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2018-09-07 |