| NPI | 1962709733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 81770) |
| Additional Taxonomies | 1744R1102X Specialist, Research Study (Licence: NY 81770) |
| Enumeration Date | 2011-02-14 |
| Last Update Date | 2011-02-14 |