| NPI | 1750649885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 247ZC0005X Pathology, Clinical Laboratory Director, Non-physician (Licence: FL CRT32194) |
| Additional Taxonomies | 2471N0900X Radiologic Technologist, Nuclear Medicine Technology (Licence: FL CRT32194) |
| Enumeration Date | 2012-04-26 |
| Last Update Date | 2012-04-26 |