| NPI | 1629361787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CT 55811) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207ZH0000X Pathology, Hematology (Licence: CT 55811) | |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2022-07-21 |