| NPI | 1861255002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246RP1900X Technician, Pathology, Phlebotomy |
| Additional Taxonomies | 246RM2200X Technician, Pathology, Medical Laboratory |
| Enumeration Date | 2024-01-31 |
| Last Update Date | 2024-01-31 |