| NPI | 1316907876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO 19391) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: CO 19391) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2008-04-09 |