NPI | 1134386725 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 174400000X Specialist |
Additional Taxonomies | 246Z00000X Specialist/Technologist, Other |
246ZS0410X Specialist/Technologist, Other, Surgical Technologist | |
Enumeration Date | 2008-05-21 |
Last Update Date | 2019-05-10 |