NPI | 1932302858 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 173000000X Legal Medicine (Licence: MN 16809) |
Additional Taxonomies | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: MN 16809) |
Enumeration Date | 2007-06-07 |
Last Update Date | 2007-07-08 |