| NPI | 1700748159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247200000X Technician, Other (Licence: LA 100599) |
| Additional Taxonomies | 247200000X Technician, Other (Licence: TX 100599) |
| 247200000X Technician, Other (Licence: AR 100599) | |
| Enumeration Date | 2025-11-24 |
| Last Update Date | 2026-01-16 |