| NPI | 1821413162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 156F00000X Technician/Technologist |
| Additional Taxonomies | 156F00000X Technician/Technologist (Licence: TX DR3722) |
| Enumeration Date | 2014-02-24 |
| Last Update Date | 2014-02-24 |