| NPI | 1386907392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246QM0706X Spec/Tech, Pathology, Medical Technologist (Licence: OH 6407104) |
| Additional Taxonomies | 246QC2700X Spec/Tech, Pathology, Cytotechnology (Licence: OH 03205227) |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2012-06-25 |