NPI | 1851437115 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 174400000X Specialist (Licence: OH 35-04-4388L) |
Additional Taxonomies | 174400000X Specialist (Licence: KY 33708) |
Enumeration Date | 2007-01-30 |
Last Update Date | 2007-07-08 |