| NPI | 1235271016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL POR151) |
| Additional Taxonomies | 174400000X Specialist (Licence: AL 183) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2008-02-04 |