NPI | 1265873608 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: NJ 25MS00014100) |
Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: FL DI 43353) |
291U00000X Clinical Medical Laboratory (Licence: NY AMJAM1) | |
Enumeration Date | 2013-07-15 |
Last Update Date | 2015-07-02 |