| NPI | 1407299100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX T6858) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: LA MD.304185) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA A155690) | |
| Enumeration Date | 2013-04-11 |
| Last Update Date | 2022-07-28 |