| NPI | 1891321774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CO DR.0077307) |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2026-03-31 |