| NPI | 1871035147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TX AT4835) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX 1029109) |
| Enumeration Date | 2016-11-17 |
| Last Update Date | 2016-11-17 |