| NPI | 1598115685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MO 2017031955) |
| Additional Taxonomies | 207ZC0500X Pathology Cytopathology (Licence: MO 2017031955) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2022-04-26 |