| NPI | 1336692649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NC 2022-01487) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: MO 2020008449) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL TRN# 23487) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-08-03 |
| Last Update Date | 2022-06-14 |