| NPI | 1033222906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TX N3325) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A95151) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2013-06-25 |