| NPI | 1588738405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA CA9485) |
| Additional Taxonomies | 174400000X Specialist (Licence: MT 2476PT) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2017-03-23 |