| NPI | 1821480880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WA MD60755267) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: WA MD60755267) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NE 30060) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-02-28 |
| Last Update Date | 2023-10-02 |