| NPI | 1417775099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZM0300X Pathology Medical Microbiology (Licence: CA DRI044) |
| Additional Taxonomies | 246QM0900X Specialist/Technologist, Pathology Microbiology (Licence: CA MTE670) |
| 246Z00000X Specialist/Technologist, Other (Licence: IL 669) | |
| Enumeration Date | 2024-10-01 |
| Last Update Date | 2024-10-01 |