| NPI | 1306263470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZS0410X Specialist/Technologist, Other, Surgical Technologist (Licence: CA 13-0200) |
| Additional Taxonomies | 2471C3402X Radiologic Technologist, Radiography (Licence: CA RHT00103971) |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2014-03-26 |