| NPI | 1457268971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246RP1900X Technician, Pathology, Phlebotomy (Licence: H9A8D3E6) |
| Additional Taxonomies | 146E00000X (Licence: KY 1621-P) |
| 156F00000X Technician/Technologist (Licence: H9A87D3E6) | |
| Enumeration Date | 2026-08-27 |
| Last Update Date | 2026-08-27 |