| NPI | 1508447947 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZC0006X Pathology, Clinical Pathology (Licence: IL 125.078995) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| Enumeration Date | 2021-04-17 | 
| Last Update Date | 2021-07-14 |