NPI | 1730426644 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 174400000X Specialist (Licence: OH 35.040170) |
Additional Taxonomies | 174400000X Specialist (Licence: FL me94656) |
Enumeration Date | 2013-01-11 |
Last Update Date | 2013-01-11 |