| NPI | 1487114419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2026-0038) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: FL ME176210) |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2026-04-13 |