NPI | 1730169590 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 174400000X Specialist (Licence: MD D36652) |
Additional Taxonomies | 174400000X Specialist (Licence: VA 0101040613) |
Enumeration Date | 2006-01-18 |
Last Update Date | 2007-11-29 |