| NPI | 1043233604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 173000000X Legal Medicine (Licence: TX H8543) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX H8543) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2018-07-02 |