| NPI | 1891031472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: GA 13853) |
| Additional Taxonomies | 171W00000X Contractor (Licence: GA 13853) |
| Enumeration Date | 2012-12-30 |
| Last Update Date | 2012-12-30 |