| NPI | 1124836069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202C00000X Independent Medical Examiner (Licence: NY 932851) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: NY 932851) |
| Enumeration Date | 2024-12-23 |
| Last Update Date | 2024-12-23 |