| NPI | 1306960919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 173000000X Legal Medicine (Licence: WA MA0003261) |
| Additional Taxonomies | 174400000X Specialist (Licence: WA MA00003261) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2007-07-08 |