NPI | 1215152970 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
Additional Taxonomies | 246ZX2200X Specialist/Technologist, Other, Orthopedic Assistant |
Enumeration Date | 2007-04-16 |
Last Update Date | 2014-11-07 |