| NPI | 1861066896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZH0000X Pathology, Hematology (Licence: PA MD487739) |
| Additional Taxonomies | 208D00000X General Practice (Licence: RI MD19611) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: RI LP05316) | |
| Enumeration Date | 2021-05-14 |
| Last Update Date | 2025-06-16 |