| NPI | 1558345124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: IA 22334) |
| Additional Taxonomies | 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: SD 3935) |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2007-07-09 |