| NPI | 1619414497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 247ZC0005X Pathology, Clinical Laboratory Director, Non-physician (Licence: CA DRK00000041) |
| Additional Taxonomies | 247ZC0005X Pathology, Clinical Laboratory Director, Non-physician (Licence: FL DI47004) |
| Enumeration Date | 2017-01-31 |
| Last Update Date | 2017-01-31 |