NPI | 1396295226 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 246ZX2200X Specialist/Technologist, Other, Orthopedic Assistant |
Additional Taxonomies | 246ZS0410X Specialist/Technologist, Other, Surgical Technologist |
Enumeration Date | 2016-10-04 |
Last Update Date | 2016-10-04 |