| NPI | 1588050157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0007X Pathology, Molecular Genetic Pathology (Licence: UT 11184892-1205) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2019-06-11 |