| NPI | 1154837748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247ZC0005X Pathology Clinical Laboratory Director, Non-physician (Licence: TX 1154837748) |
| Additional Taxonomies | 207ZC0006X Pathology Clinical Pathology (Licence: TX 1154837748) |
| 246RP1900X Technician, Pathology Phlebotomy | |
| Enumeration Date | 2017-12-19 |
| Last Update Date | 2023-06-14 |