| NPI | 1376107250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other Surgical Assistant (Licence: CO 187722) |
| Additional Taxonomies | 246ZS0410X Specialist/Technologist, Other Surgical Technologist (Licence: CO 187722) |
| Enumeration Date | 2019-04-26 |
| Last Update Date | 2019-04-26 |