| NPI | 1295249977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: DC SA0196) |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: TX SA00773) |
| 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: VA 0136000318) | |
| Enumeration Date | 2017-11-17 |
| Last Update Date | 2021-01-05 |