| NPI | 1336339159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MD457760) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MN 50972) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OH 35.09201) | |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2016-06-22 |