| NPI | 1396115333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246QM0706X Spec/Tech, Pathology, Medical Technologist (Licence: CA 229309) |
| Additional Taxonomies | 246R00000X Technician, Pathology (Licence: CA 64951) |
| Enumeration Date | 2015-10-02 |
| Last Update Date | 2015-10-02 |