| NPI | 1568033587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246QM0706X Spec/Tech, Pathology, Medical Technologist |
| Additional Taxonomies | 246Z00000X Specialist/Technologist, Other |
| Enumeration Date | 2021-07-09 |
| Last Update Date | 2021-07-14 |