| NPI | 1346344355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: GA 34896) |
| Additional Taxonomies | 174400000X Specialist (Licence: AL DO376) |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2015-07-27 |