| NPI | 1255944310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other Surgical Assistant (Licence: SA00954) |
| Additional Taxonomies | 246ZS0410X Specialist/Technologist, Other Surgical Technologist (Licence: 198093) |
| Enumeration Date | 2020-08-28 |
| Last Update Date | 2024-06-27 |