| NPI | 1437546298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246RP1900X Technician, Pathology, Phlebotomy |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: UT 8875609-4701) |
| 246RM2200X Technician, Pathology, Medical Laboratory | |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2024-10-27 |