NPI | 1598723272 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 174400000X Specialist (Licence: NY 191616) |
Additional Taxonomies | 174400000X Specialist (Licence: NJ 25MA06811400) |
Enumeration Date | 2006-05-03 |
Last Update Date | 2021-09-16 |