| NPI | 1912946278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZB0001X Pathology Blood Banking & Transfusion Medicine (Licence: WA MD.MD.60250244) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX K1263) |
| 207ZB0001X Pathology Blood Banking & Transfusion Medicine (Licence: TX K2163) | |
| 207ZB0001X Pathology Blood Banking & Transfusion Medicine (Licence: AZ 53404) | |
| 207ZB0001X Pathology Blood Banking & Transfusion Medicine (Licence: CO 46104) | |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2023-03-07 |