| NPI | 1487944930 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: LA MD.301728)  | 
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: SC MD37690)  | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-17 | 
| Last Update Date | 2016-07-22 |