| NPI | 1811266570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: OH 35.024339) |
| Additional Taxonomies | 1744R1102X Specialist, Research Study (Licence: OH 35.024339) |
| Enumeration Date | 2011-12-23 |
| Last Update Date | 2011-12-23 |