| NPI | 1255471405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NC CP003475) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC C50369) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2011-10-28 |