| NPI | 1629431291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA A168705) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207ZH0000X Pathology, Hematology (Licence: CA A168705) | |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2023-08-04 |