| NPI | 1972731982 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: MN 62730) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT194719) | 
| Enumeration Date | 2009-06-29 | 
| Last Update Date | 2018-03-17 |