| NPI | 1699611012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246Q00000X Spec/Tech, Pathology |
| Additional Taxonomies | 247ZC0005X Pathology, Clinical Laboratory Director, Non-physician |
| Enumeration Date | 2026-04-27 |
| Last Update Date | 2026-04-27 |