| NPI | 1538629852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NM MD2025-0814) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MI 4301511364) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-22 |
| Last Update Date | 2025-08-07 |