NPI | 1427591759 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other Surgical Assistant (Licence: NV 162335) |
Additional Taxonomies | 363AS0400X Physician Assistant Surgical |
Enumeration Date | 2016-11-17 |
Last Update Date | 2016-11-17 |