| NPI | 1912669755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247ZC0005X Pathology, Clinical Laboratory Director, Non-physician |
| Additional Taxonomies | 246QL0900X Spec/Tech, Pathology, Laboratory Management |
| 246RM2200X Technician, Pathology, Medical Laboratory | |
| Enumeration Date | 2021-10-08 |
| Last Update Date | 2021-10-08 |