| NPI | 1750055984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: MD 00000) |
| Enumeration Date | 2021-08-02 |
| Last Update Date | 2024-11-25 |