NPI | 1063455541 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: AL 1-083260) |
Additional Taxonomies | 173000000X Legal Medicine (Licence: NY 5064) |
Enumeration Date | 2006-06-13 |
Last Update Date | 2016-11-26 |