| NPI | 1114091931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE RICHARD ERIKSSON Business Owner 703-802-6304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 173000000X Legal Medicine (Licence: VA 101048518) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2020-08-22 |