| NPI | 1679925697 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: IN 01088109A)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MO 2016015268)  | |
| 207ZP0213X Pathology, Pediatric Pathology (Licence: PA MT222205)  | |
| Enumeration Date | 2016-07-02 | 
| Last Update Date | 2022-07-13 |