| NPI | 1528354883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TN 54324) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: NC 201800847) |
| 174400000X Specialist (Licence: MS 24337) | |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: SC 52043) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NC 201800847) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: SC 52043) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2011014988) | |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2018-05-30 |