| NPI | 1699959395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 202C00000X Independent Medical Examiner (Licence: TN MD0000036065) |
| Additional Taxonomies | 202C00000X Independent Medical Examiner (Licence: FL ME 21426) |
| Enumeration Date | 2007-12-18 |
| Last Update Date | 2007-12-18 |