| NPI | 1255451712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: FL ME 48985) |
| Additional Taxonomies | 207ZC0006X Pathology, Clinical Pathology (Licence: FL ME48985) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2022-11-10 |