NPI | 1235271107 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 246ZS0410X Specialist/Technologist, Other, Surgical Technologist |
Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
Enumeration Date | 2007-02-13 |
Last Update Date | 2014-10-15 |