| NPI | 1437498656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: CO SA.0001707) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: CO 026866) |
| Enumeration Date | 2013-02-07 |
| Last Update Date | 2015-08-30 |