| NPI | 1942318696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA A90845) |
| Additional Taxonomies | 171W00000X Contractor (Licence: CA A90845) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2012-04-17 |