| NPI | 1760899652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: ND PT16241) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: ND 16247) | |
| Enumeration Date | 2014-07-13 |
| Last Update Date | 2023-04-20 |