| NPI | 1629254065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: WA MD60022112) |
| Additional Taxonomies | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: GA 059389) |
| 207ZH0000X Pathology, Hematology (Licence: GA 059389) | |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2013-01-10 |