| NPI | 1033106158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: GA 053852) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 53852) |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2016-09-02 |