| NPI | 1821194937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM 87-278) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: NM 87278) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2017-04-17 |