| NPI | 1336145218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: AR C5323) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: AR C5323) |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2017-06-27 |