| NPI | 1336490028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171W00000X Contractor (Licence: TN 70304) |
| Additional Taxonomies | 171W00000X Contractor |
| 171W00000X Contractor | |
| Enumeration Date | 2012-09-21 |
| Last Update Date | 2012-09-21 |