| NPI | 1366481145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: WA 00014699) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: WA 00014699) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2009-10-27 |