| NPI | 1730731902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MN 73511) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: KY 0000000) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX 782449) | |
| Enumeration Date | 2019-07-09 |
| Last Update Date | 2024-05-15 |