| NPI | 1831399880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247ZC0005X Pathology, Clinical Laboratory Director, Non-physician (Licence: LA 321037) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2022-01-05 |