| NPI | 1245293687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 184552) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: NY 184552) |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2010-09-17 |