| NPI | 1174778559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247200000X Technician, Other (Licence: WA P46) |
| Additional Taxonomies | 247200000X Technician, Other (Licence: WA O75) |
| Enumeration Date | 2008-11-26 |
| Last Update Date | 2008-11-26 |