| NPI | 1629554738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZM0300X Pathology Medical Microbiology (Licence: FL DI30550) |
| Additional Taxonomies | 247ZC0005X Pathology Clinical Laboratory Director, Non-physician (Licence: FL DI30550) |
| Enumeration Date | 2018-07-12 |
| Last Update Date | 2023-12-23 |