| NPI | 1750777223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: AZ 80978) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207ZD0900X Pathology, Dermatopathology (Licence: LA 312151) | |
| Enumeration Date | 2015-04-12 |
| Last Update Date | 2026-05-21 |