| NPI | 1245473321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other Surgical Assistant (Licence: IN NONE) |
| Additional Taxonomies | 246ZS0410X Specialist/Technologist, Other Surgical Technologist |
| Enumeration Date | 2009-04-20 |
| Last Update Date | 2022-11-15 |