| NPI | 1568842771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: VA 0136000069) |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: DC SA0165) |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2019-01-02 |