| NPI | 1609193069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: DC MD04625) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 255904) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: HI MD14402) | |
| Enumeration Date | 2010-04-26 |
| Last Update Date | 2018-07-31 |