| NPI | 1083274799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246Z00000X Specialist/Technologist, Other (Licence: GA 296) |
| Additional Taxonomies | 246Z00000X Specialist/Technologist, Other (Licence: GA 458) |
| Enumeration Date | 2019-06-14 |
| Last Update Date | 2019-06-14 |