NPI | 1801846910 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 174400000X Specialist (Licence: MO 1099600) |
Additional Taxonomies | 174400000X Specialist (Licence: KS 04-22588) |
Enumeration Date | 2006-05-11 |
Last Update Date | 2021-01-15 |