| NPI | 1477143733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247ZC0005X Pathology, Clinical Laboratory Director, Non-physician (Licence: FL DL49402) |
| Additional Taxonomies | 246QC1000X Spec/Tech, Pathology, Chemistry (Licence: DE 1225) |
| 246QI0000X Spec/Tech, Pathology, Immunology | |
| 246QL0901X Spec/Tech, Pathology, Laboratory Management, Diplomate | |
| 246ZB0500X Specialist/Technologist, Other, Biochemist | |
| Enumeration Date | 2021-01-21 |
| Last Update Date | 2021-01-21 |