NPI | 1275082406 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 174400000X Specialist (Licence: MO 2015015579) |
Additional Taxonomies | 174400000X Specialist (Licence: IL 3239) |
Enumeration Date | 2016-09-29 |
Last Update Date | 2016-09-29 |