| NPI | 1841360484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: AZ 4105) |
| Additional Taxonomies | 209800000X Legal Medicine (Licence: AZ 4105) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2020-08-05 |