Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | 3630 | MA |
NPI | 1891261145 |
---|---|
Provider Name | Dylon Pyne |
First Address | South Easton, MA 02375-1796 |
Second Address | South Easton, MA 02375-1796 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2018 |
Last Update Date | 15/10/2018 |