NPI | 1467815779 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 174400000X Specialist (Licence: SC 4358) |
Additional Taxonomies | 174400000X Specialist (Licence: GA VET007317) |
Enumeration Date | 2016-04-04 |
Last Update Date | 2020-10-22 |