| NPI | 1710120548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: IN 01093324A) |
| Additional Taxonomies | 2085R0001X (Licence: KY 51914) |
| 2085R0001X (Licence: GA 072363) | |
| Enumeration Date | 2009-04-09 |
| Last Update Date | 2024-05-22 |