| NPI | 1871937136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 202C00000X Independent Medical Examiner (Licence: MI 4301103829) |
| Additional Taxonomies | 202C00000X Independent Medical Examiner (Licence: WA ML60697085) |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2025-10-24 |