| NPI | 1487276721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZH0000X Pathology, Hematology (Licence: OH 35.156743) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OH 35.156743) | |
| Enumeration Date | 2020-05-09 |
| Last Update Date | 2026-07-07 |