| NPI | 1730472655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NH 17954) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX 0040859) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-05-25 |
| Last Update Date | 2021-08-03 |