| NPI | 1932142023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: ME TD061026) |
| Additional Taxonomies | 174400000X Specialist (Licence: CO 16535) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2010-12-29 |