| NPI | 1598269680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NC 2024-00042) |
| Additional Taxonomies | 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: MN 71381) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116037559) | |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2024-07-08 |