| NPI | 1518113455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: IL 036.129426) |
| Additional Taxonomies | 2085R0001X (Licence: CA A108319) |
| 2085R0001X (Licence: IN 01070177A) | |
| Enumeration Date | 2008-08-12 |
| Last Update Date | 2025-05-22 |