| NPI | 1922497700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0007X Pathology, Molecular Genetic Pathology (Licence: CA A152642) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2015-01-15 |
| Last Update Date | 2021-09-01 |