NPI | 1720492515 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 174400000X Specialist (Licence: IA 005108) |
Additional Taxonomies | 174400000X Specialist (Licence: IL 070019829) |
Enumeration Date | 2014-06-19 |
Last Update Date | 2014-06-19 |