| NPI | 1790096246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202C00000X Independent Medical Examiner (Licence: MN 32345) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2024-01-22 |