| NPI | 1669786810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX Q3337) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME115046) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN14061) | |
| Enumeration Date | 2010-07-29 |
| Last Update Date | 2022-03-29 |