| NPI | 1649257163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: IL 036-088433) |
| Additional Taxonomies | 174400000X Specialist (Licence: WI 35393) |
| 174400000X Specialist (Licence: IN 01059554A) | |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2007-07-09 |