| NPI | 1083871412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: DC 10000713) |
| Additional Taxonomies | 1744R1102X Specialist, Research Study (Licence: cert05836) |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2008-11-06 |