| NPI | 1588776181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 9221) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: PR 9221) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2017-08-31 |