| NPI | 1841450046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: VA 0101236997) |
| Additional Taxonomies | 171W00000X Contractor (Licence: VA 0101236997) |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2008-06-11 |