| NPI | 1124319165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: DC SA0118) |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: IL 238.000374) | |
| Enumeration Date | 2011-04-25 |
| Last Update Date | 2014-08-19 |