NPI | 1962404228 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 174400000X Specialist (Licence: TN MD8019) |
Additional Taxonomies | 174400000X Specialist (Licence: TN 0008019) |
Enumeration Date | 2005-06-01 |
Last Update Date | 2017-01-09 |