| NPI | 1174796544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: IN 01072092A) |
| Additional Taxonomies | 2085R0001X (Licence: KY 54177) |
| 2085R0001X (Licence: TX BP1-0034813) | |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2024-03-15 |