| NPI | 1841351566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: FL ME160859) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: KY 30486) |
| 291U00000X Clinical Medical Laboratory (Licence: IN 01046668A) | |
| 291U00000X Clinical Medical Laboratory (Licence: VA 0101238949) | |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2023-07-06 |