| NPI | 1760626279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247ZC0005X Pathology, Clinical Laboratory Director, Non-physician (Licence: GA 163311) |
| Additional Taxonomies | 246RM2200X Technician, Pathology, Medical Laboratory (Licence: GA 163311) |
| Enumeration Date | 2009-04-28 |
| Last Update Date | 2009-04-28 |