| NPI | 1770637266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TN 48478) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207ZC0500X Pathology, Cytopathology (Licence: MD D69945) | |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2013-08-05 |