| NPI | 1326466095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: KS 04-43492) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NM MD2018-0109) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MO 2021004564) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2026-06-23 |