| NPI | 1215984513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 173000000X Legal Medicine (Licence: CA G75391) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G75391) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2012-05-31 |