| NPI | 1801088984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: KS 0439527) |
| Additional Taxonomies | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: MN 53935) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: OK 29787) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME121097) | |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2016-11-25 |