| NPI | 1467171462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2022026934) |
| 170100000X Medical Genetics, Ph.D. Medical Genetics | |
| 246QL0900X Spec/Tech, Pathology, Laboratory Management | |
| Enumeration Date | 2022-08-23 |
| Last Update Date | 2026-03-27 |