| NPI | 1497973721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202C00000X Independent Medical Examiner (Licence: NY 73738) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 73738) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2007-07-08 |