| NPI | 1649545500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: RI OTA00549) |
| Additional Taxonomies | 174400000X Specialist (Licence: RI 224Z00000X) |
| Enumeration Date | 2012-03-12 |
| Last Update Date | 2012-03-12 |