| NPI | 1588723118 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NC 2017-02451) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AL 9388) |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: MN 104839) | |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: MN 53388) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AL 29932) | |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2017-12-11 |