| NPI | 1407851298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 10646) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: PR 10646) |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2023-06-14 |