| NPI | 1073606117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: WA FE60096740) |
| Additional Taxonomies | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: WA MD60142058) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2024-02-27 |