| NPI | 1942596622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZH0000X Pathology, Hematology (Licence: MN 55517) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: MN 55517) | |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2020-10-06 |