| NPI | 1073589602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246ZX2200X Specialist/Technologist, Other, Orthopedic Assistant (Licence: NY O000066-) |
| Additional Taxonomies | 246ZS0410X Specialist/Technologist, Other, Surgical Technologist |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2023-02-02 |