| NPI | 1215334669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247ZC0005X Pathology, Clinical Laboratory Director, Non-physician (Licence: NY SUXXZ1) |
| Additional Taxonomies | 247ZC0005X Pathology, Clinical Laboratory Director, Non-physician (Licence: NJ 25MS00016100) |
| 247ZC0005X Pathology, Clinical Laboratory Director, Non-physician (Licence: NV 33537DIR-0) | |
| 247ZC0005X Pathology, Clinical Laboratory Director, Non-physician (Licence: FL DI 45675) | |
| Enumeration Date | 2014-12-01 |
| Last Update Date | 2014-12-01 |