| NPI | 1821056425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X (Licence: IN 01079213A) |
| Additional Taxonomies | 2085R0001X (Licence: NV 11906) |
| 2085R0001X (Licence: MT 11876) | |
| 2085R0001X (Licence: AK S5969) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2024-02-28 |