NPI | 1588063887 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2014-08-22 |
Last Update Date | 2022-08-10 |