| NPI | 1073277836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: TX 207934) |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| 246ZS0410X Specialist/Technologist, Other, Surgical Technologist | |
| Enumeration Date | 2021-10-27 |
| Last Update Date | 2025-05-05 |