| NPI | 1033300512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246Z00000X Specialist/Technologist, Other (Licence: FL 01413575) |
| Additional Taxonomies | 246QL0900X Spec/Tech, Pathology, Laboratory Management (Licence: FL TN36736) |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2007-08-08 |