| NPI | 1962081877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: MI 4301516894) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: CA A193802) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-04-07 |
| Last Update Date | 2026-07-13 |