| NPI | 1841828134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: CA A185269) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA A185269) |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2025-05-01 |