| NPI | 1821209339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: VA 0101246357) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: MD D74367) |
| 207ZC0500X Pathology, Cytopathology (Licence: VA 0101246357) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MD D74367) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116018315) | |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2012-06-20 |