| NPI | 1225208945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: NE 47) |
| Additional Taxonomies | 208600000X Surgery (Licence: NE 47) |
| Enumeration Date | 2008-03-10 |
| Last Update Date | 2020-09-15 |