| NPI | 1891159539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NM MD2021-0450) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM MD2021-0450) |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: WA MDRE.ML.60659372) | |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2022-06-08 |