| NPI | 1447253802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: KS 0413831) |
| Additional Taxonomies | 174400000X Specialist (Licence: NE 10805) |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2007-07-08 |