| NPI | 1811911688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: AR PTA 1269) |
| Additional Taxonomies | 174400000X Specialist (Licence: AR AT325) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2007-07-08 |