| NPI | 1811415615 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZC0500X Pathology, Cytopathology (Licence: TX T3970) | 
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: CA A167302) | 
| 207ZP0101X Pathology, Anatomic Pathology (Licence: TX T3970) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-09-01 | 
| Last Update Date | 2021-12-16 |