| NPI | 1699389049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ACN1297) |
| Additional Taxonomies | 207ZC0006X Pathology, Clinical Pathology (Licence: FL ACN1297) |
| Enumeration Date | 2020-09-02 |
| Last Update Date | 2025-07-21 |