| NPI | 1124445218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: WA OP61352833) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: OR DO192251) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OR DO192251) | |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2022-12-13 |