| NPI | 1770319741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: NY SHENL2) |
| Additional Taxonomies | 207KI0005X Allergy & Immunology, Clinical & Laboratory Immunology (Licence: NY SHENL2) |
| 247ZC0005X Pathology, Clinical Laboratory Director, Non-physician (Licence: NY SHENL2) | |
| Enumeration Date | 2024-09-09 |
| Last Update Date | 2024-09-09 |