| NPI | 1497945216 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OH 35.143834) | 
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: MI 4301103725) | 
| 207ZP0101X Pathology, Anatomic Pathology (Licence: MI 4301103725) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MN 51263) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MI 4301103725) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-07-27 | 
| Last Update Date | 2022-04-21 |