| NPI | 1356845010 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207ZN0500X Pathology, Neuropathology (Licence: VA 0101281286)  | 
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: IL 125.072397)  | 
| 207ZP0101X Pathology, Anatomic Pathology (Licence: VA 0101281286)  | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-19 | 
| Last Update Date | 2024-07-01 |