| NPI | 1629444005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MI 43010503539) |
| Additional Taxonomies | 207ZF0201X Pathology, Forensic Pathology (Licence: CA 43010503539) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA 43010503539) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2022-01-19 |