| NPI | 1750734760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZH0000X Pathology, Hematology (Licence: OH 35.138279) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301110276) |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2020-05-21 |