| NPI | 1487071668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207ZF0201X Pathology, Forensic Pathology (Licence: CA A148787) |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2020-09-17 |