| NPI | 1205836509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME68627) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: FL ME68627) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2023-03-07 |