| NPI | 1760732143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: MI 4301100734) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OK 33267) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301100734) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 5315055196) | |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2018-07-10 |