| NPI | 1972508794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 173000000X Legal Medicine (Licence: PA 022953E) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA 022953E) |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2015-10-01 |