| NPI | 1518999374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: CA A31717) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A31717) |
| 208600000X Surgery (Licence: CA A31717) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2023-12-20 |