| NPI | 1649334863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 242T00000X Perfusionist (Licence: OK LP7) |
| Additional Taxonomies | 247200000X Technician, Other (Licence: OK LP7) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2011-08-24 |