| NPI | 1972009066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246Q00000X Spec/Tech, Pathology (Licence: FL TC52623) |
| Additional Taxonomies | 246RM2200X Technician, Pathology, Medical Laboratory |
| Enumeration Date | 2018-04-05 |
| Last Update Date | 2024-08-06 |