| NPI | 1043003445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246Q00000X Spec/Tech, Pathology (Licence: HI 755774) |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant |
| Enumeration Date | 2025-05-28 |
| Last Update Date | 2025-05-28 |