| NPI | 1780103879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 202C00000X Independent Medical Examiner (Licence: ME MD21729) |
| Additional Taxonomies | 208600000X Surgery (Licence: ME MD21729) |
| Enumeration Date | 2017-09-11 |
| Last Update Date | 2017-09-11 |