| NPI | 1699386235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246RP1900X Technician, Pathology, Phlebotomy (Licence: MD 20-0204R15) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: TX 605340) |
| 174400000X Specialist | |
| Enumeration Date | 2020-08-16 |
| Last Update Date | 2020-11-23 |