Individual
JEFFERSON UY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MT ASCP
Taxonomy
Speciality
Code
Description
License number
State
246QM0706X
Medical Technologist
Primary
09229
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09229
LABORATORY TECHNOLOGIST
WV
01
—
3568
ASCP
—
01
—
MTA00045207
CCLS
CA
01
—
TN46183
FLORIDA CLINICAL LABORATORY TECHNOLOGIST
FL
Enumeration date
04/18/2014
Last updated
06/05/2014
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