NPI | 1598054710 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: CT 07D0995237) |
Enumeration Date | 2011-03-29 |
Last Update Date | 2019-02-26 |