| NPI | 1326044330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: GA 068549) |
| Additional Taxonomies | 2086S0129X (Licence: KY 24250) |
| 2086S0129X (Licence: IN 01066838A) | |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2012-12-10 |