| NPI | 1952544264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: RI 13637) |
| Enumeration Date | 2009-04-16 |
| Last Update Date | 2011-12-20 |