| NPI | 1548348766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 173000000X Legal Medicine (Licence: NY 177426) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 177426) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2009-11-12 |