| NPI | 1730519042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: WI CO003055) |
| Additional Taxonomies | 174400000X Specialist (Licence: WI C50345) |
| Enumeration Date | 2013-11-22 |
| Last Update Date | 2013-11-22 |