NPI | 1962728063 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 174400000X Specialist (Licence: FL 193400000x) |
Additional Taxonomies | 174400000X Specialist (Licence: FL ME24402) |
Enumeration Date | 2010-04-14 |
Last Update Date | 2010-04-14 |