| NPI | 1962081877 |
|---|---|
| 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: CA A193802) |
| Enumeration Date | 2021-04-07 |
| Last Update Date | 2026-03-06 |