| NPI | 1528258357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: FL OS20333) |
| Additional Taxonomies | 2086S0129X (Licence: GA 95292) |
| 2086S0129X (Licence: NC 2014-01635) | |
| 2086S0129X (Licence: AL DO.3424) | |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2024-09-20 |