| NPI | 1235444167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor (Licence: IN 05010164A) |
| Additional Taxonomies | 171W00000X Contractor (Licence: MI 5501014585) |
| Enumeration Date | 2010-08-16 |
| Last Update Date | 2010-08-16 |