| NPI | 1598877698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 202C00000X Independent Medical Examiner (Licence: CA G21120) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA 94598-3012) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2024-06-05 |