| NPI | 1588962609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246RM2200X Technician, Pathology, Medical Laboratory (Licence: IL 14d2018991) |
| Additional Taxonomies | 247ZC0005X Pathology, Clinical Laboratory Director, Non-physician (Licence: IL 14d2018991) |
| Enumeration Date | 2011-03-14 |
| Last Update Date | 2011-03-14 |