| NPI | 1265570352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: OH OH35031279H) |
| Additional Taxonomies | 174400000X Specialist (Licence: IN IN01026640) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2007-07-09 |