| NPI | 1790561587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247ZC0005X Pathology, Clinical Laboratory Director, Non-physician |
| Additional Taxonomies | 246QB0000X Spec/Tech, Pathology, Blood Banking |
| Enumeration Date | 2023-09-06 |
| Last Update Date | 2026-08-13 |