| NPI | 1114060720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA G51854) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: CA G51854) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2016-03-02 |