| NPI | 1104882877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: AZ 30059) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: AZ 30059) |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2007-12-28 |