| NPI | 1407173099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: TX Q1774) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX Q1774) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-04-22 |
| Last Update Date | 2018-03-21 |