| NPI | 1720516925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: SC 51109) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: SC LL51109) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM MD2021-0229) | |
| Enumeration Date | 2017-06-01 |
| Last Update Date | 2022-08-02 |