| NPI | 1265415418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: IA A03802) |
| Additional Taxonomies | 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: SD 0313) |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2020-10-29 |