| NPI | 1881076230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 246RP1900X Technician, Pathology, Phlebotomy (Licence: WA PC60573205) |
| 246Z00000X Specialist/Technologist, Other (Licence: WA MR60568577) | |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2018-08-29 |