NPI | 1356580534 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 171W00000X Contractor (Licence: MD 22758) |
Additional Taxonomies | 171W00000X Contractor (Licence: IN 05009782a) |
Enumeration Date | 2009-02-12 |
Last Update Date | 2023-03-19 |