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 |