| NPI | 1306084652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: HI MD-6963) |
| Additional Taxonomies | 207ZC0006X Pathology, Clinical Pathology (Licence: HI MD-6963) |
| Enumeration Date | 2009-01-24 |
| Last Update Date | 2009-01-24 |