| NPI | 1518731314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246QM0706X Spec/Tech, Pathology, Medical Technologist |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2023-11-13 |
| Last Update Date | 2023-11-13 |