NPI | 1558507319 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 246ZS0410X Specialist/Technologist, Other, Surgical Technologist (Licence: AZ 00-211) |
Additional Taxonomies | 246ZS0410X Specialist/Technologist, Other, Surgical Technologist (Licence: CO 83801) |
Enumeration Date | 2008-12-29 |
Last Update Date | 2008-12-29 |