| NPI | 1194178780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: WA 1831957026) |
| Additional Taxonomies | 247200000X (Licence: WA MR60846454) |
| 251J00000X Nursing Care (Licence: NM NM0049261107E) | |
| 207Q00000X Family Medicine (Licence: WA 1194178780) | |
| 246RP1900X Technician, Pathology, Phlebotomy (Licence: WA PC60777046) | |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2024-03-28 |