NPI | 1275908295 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other Surgical Assistant (Licence: OH 163169) |
Additional Taxonomies | 246ZS0410X Specialist/Technologist, Other Surgical Technologist (Licence: OH 163169) |
Enumeration Date | 2015-12-02 |
Last Update Date | 2015-12-02 |