| NPI | 1760410070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 173000000X Legal Medicine (Licence: TX D7656) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: TX d7686) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2007-07-08 |