| NPI | 1316525892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207ZC0006X Pathology Clinical Pathology (Licence: MA PENDING) |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2021-07-26 |