| NPI | 1730306358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036-052031) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: IL 036052036) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2022-11-03 |