| NPI | 1174036222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Additional Taxonomies | 146M00000X Emergency Medical Technician, Intermediate |
| 1744R1103X Specialist, Research Data Abstracter/Coder | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-11-12 |
| Last Update Date | 2018-03-17 |