NPI | 1144337619 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 174400000X Specialist (Licence: OR MD13692) |
Additional Taxonomies | 174400000X Specialist (Licence: WA MD00034604) |
Enumeration Date | 2006-08-23 |
Last Update Date | 2007-07-18 |