| NPI | 1962586461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: VA 0101018720) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: VA 0101018720) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2011-12-02 |