| NPI | 1063240463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 202C00000X Independent Medical Examiner (Licence: CA CPT-02166464) |
| Additional Taxonomies | 156F00000X Technician/Technologist |
| 171W00000X Contractor | |
| Enumeration Date | 2024-07-25 |
| Last Update Date | 2024-10-03 |