| NPI | 1598234569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 202C00000X Independent Medical Examiner (Licence: CA G61985) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA G61985) |
| Enumeration Date | 2018-11-19 |
| Last Update Date | 2019-02-13 |