| NPI | 1669581518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 242T00000X Perfusionist (Licence: CA 799111) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA 283697) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2007-09-16 |