| NPI | 1598029902 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZF0201X Pathology, Forensic Pathology (Licence: CO TL.0005949)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301100927)  | 
| Enumeration Date | 2012-06-29 | 
| Last Update Date | 2016-06-05 |