| NPI | 1043505290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202C00000X Independent Medical Examiner (Licence: MD D34977) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D34977) |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2011-06-16 |