| NPI | 1588954408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZF0201X Pathology, Forensic Pathology (Licence: NM MD2016-0254) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2011-04-12 |
| Last Update Date | 2016-06-30 |