| NPI | 1881897205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: ID 2261978) |
| Additional Taxonomies | 2086S0129X (Licence: IL 036116332) |
| 2086S0129X (Licence: NH LT-3493) | |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2024-09-05 |