| NPI | 1306475579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 242T00000X Perfusionist (Licence: TX FPF02000140) |
| Additional Taxonomies | 242T00000X Perfusionist (Licence: TX PPF02000069) |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2021-02-02 |