| NPI | 1780956557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 209800000X Legal Medicine (Licence: WI 54688-20) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: WI 54688-20) |
| Enumeration Date | 2012-02-08 |
| Last Update Date | 2012-02-08 |