| NPI | 1700294790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2018-0350) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: MO 2014021937) |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: MO 2014025585) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MD462960) | |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2018-06-28 |