| 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 |