| NPI | 1629455886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: TX SS2720) |
| Additional Taxonomies | 207ZH0000X Pathology Hematology (Licence: TX S2720) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: TX S2720) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: LA 327748) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-27 |
| Last Update Date | 2022-09-19 |