| NPI | 1467414078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: FL ME106987) |
| Additional Taxonomies | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: WI 1409) |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2014-07-15 |