| NPI | 1487767190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA G833738) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G83738) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2024-02-27 |