| NPI | 1982091583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NE 34412) |
| Additional Taxonomies | 207ZD0900X Pathology Dermatopathology (Licence: NE 34412) |
| 207ZD0900X Pathology Dermatopathology (Licence: IA MD-49646) | |
| 207ZD0900X Pathology Dermatopathology (Licence: WI 75375-20) | |
| 207ZH0000X Pathology Hematology (Licence: IA MD-49646) | |
| 207ZH0000X Pathology Hematology (Licence: NE 34412) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NE MD-49646) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: WI 75375-20) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-21 |
| Last Update Date | 2022-04-25 |