| NPI | 1346232410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: PR 878) |
| Additional Taxonomies | 246QL0900X Spec/Tech, Pathology, Laboratory Management (Licence: PR 2977) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2019-06-25 |