| NPI | 1861447054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TN MD0000010436) |
| Additional Taxonomies | 174400000X Specialist (Licence: AR R-3174) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2007-07-08 |