| NPI | 1629456082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2472R0900X Technician, Other, Renal Dialysis |
| Additional Taxonomies | 2472R0900X Technician, Other, Renal Dialysis (Licence: CA 00022495) |
| Enumeration Date | 2015-05-18 |
| Last Update Date | 2018-12-23 |