| NPI | 1013094341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA C37664) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: CA C37664) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2023-03-07 |