NPI | 1073638870 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2088P0231X (Licence: SC 61243) |
Additional Taxonomies | 2088P0231X (Licence: NY 272913-1) |
2088P0231X (Licence: OH 35.086578) | |
Enumeration Date | 2007-03-20 |
Last Update Date | 2018-09-06 |