| NPI | 1679097976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZC0008X Pathology, Clinical Informatics Specialist (Licence: NV 405787) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: ZZ D-16-1125-1121-A) |
| 374K00000X Religious Nonmedical Practitioner (Licence: NV Na) | |
| Enumeration Date | 2017-07-28 |
| Last Update Date | 2022-01-20 |