NPI | 1043307655 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 174400000X Specialist (Licence: MD D0052435) |
Additional Taxonomies | 174400000X Specialist (Licence: VA 0101052540) |
Enumeration Date | 2006-10-06 |
Last Update Date | 2007-07-08 |