| NPI | 1629698543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207ZF0201X Pathology, Forensic Pathology (Licence: TX V4877) |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2026-06-13 |