| NPI | 1275736811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 202C00000X Independent Medical Examiner (Licence: VA 0101043676) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: CA G41559) |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: CA G41559) | |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2007-07-08 |