| NPI | 1770738296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MI 4301083137) |
| Additional Taxonomies | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: PA MD440351) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10030669) | |
| Enumeration Date | 2008-11-25 |
| Last Update Date | 2018-09-04 |