| NPI | 1912902248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: TX G9763) |
| Additional Taxonomies | 207ZB0001X Pathology Blood Banking & Transfusion Medicine (Licence: TX G9763) |
| 207ZB0001X Pathology Blood Banking & Transfusion Medicine (Licence: LA 016234) | |
| 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: LA 016234) | |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2007-12-21 |