| NPI | 1255009841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: HI 0000) |
| Additional Taxonomies | 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: HI 0000) |
| 103TC0700X Psychologist Clinical (Licence: HI 0000) | |
| 246QL0900X Specialist/Technologist, Pathology Laboratory Management | |
| Enumeration Date | 2021-08-31 |
| Last Update Date | 2023-02-19 |