| NPI | 1669471538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: CO 28714) |
| Additional Taxonomies | 174400000X Specialist (Licence: OK 17891) |
| 173000000X Legal Medicine | |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2016-10-10 |