| NPI | 1215439807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 156F00000X Technician/Technologist (Licence: OR RBT-18-61333) |
| Additional Taxonomies | 247200000X Technician, Other |
| Enumeration Date | 2018-02-28 |
| Last Update Date | 2021-10-01 |