| NPI | 1043316169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM 80242) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: NM 80242) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2015-08-12 |