NPI | 1013021153 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 174400000X Specialist (Licence: SC MD12478) |
Additional Taxonomies | 174400000X Specialist (Licence: SC 12478) |
Enumeration Date | 2006-08-18 |
Last Update Date | 2014-04-14 |