| NPI | 1710266952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: TN DO0000002475) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: TN DO0000002475) |
| Enumeration Date | 2011-08-05 |
| Last Update Date | 2014-11-17 |