| NPI | 1346404464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX R4130) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 247011) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 247011) | |
| 207ZD0900X Pathology, Dermatopathology (Licence: TX R4130) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: SC MMD.33015 TL) | |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2025-10-29 |