| NPI | 1518260819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247ZC0005X Pathology, Clinical Laboratory Director, Non-physician |
| Additional Taxonomies | 246Q00000X Spec/Tech, Pathology |
| Enumeration Date | 2010-12-09 |
| Last Update Date | 2014-04-03 |