| NPI | 1619929809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: WA MD00011348) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: WA 00011348) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2008-09-08 |