| NPI | 1083095319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: WA MD61527308) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: WA MD61527308) |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2024-07-24 |