NPI | 1538210042 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 174400000X Specialist (Licence: NY 275819) |
Additional Taxonomies | 174400000X Specialist (Licence: MA 227693) |
Enumeration Date | 2007-01-13 |
Last Update Date | 2023-05-19 |