| NPI | 1881219293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZF0201X Pathology, Forensic Pathology (Licence: PA MD491943) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4351046339) |
| Enumeration Date | 2020-06-11 |
| Last Update Date | 2026-02-06 |