NPI | 1982806337 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 202C00000X Independent Medical Examiner (Licence: AZ 1444) |
Additional Taxonomies | 202C00000X Independent Medical Examiner (Licence: ID 0-39) |
Enumeration Date | 2007-06-05 |
Last Update Date | 2007-07-08 |