| NPI | 1093795528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: IN 01074731A) |
| Additional Taxonomies | 2086S0129X (Licence: NE 21517) |
| 2086S0129X (Licence: IA 33729) | |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2025-04-15 |