| NPI | 1457322927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CO 36090) |
| Additional Taxonomies | 174400000X Specialist (Licence: WY 6005A) |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2010-03-29 |