NPI | 1700535630 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: TX 208501) |
Additional Taxonomies | 225500000X Specialist/Technologist |
Enumeration Date | 2022-03-18 |
Last Update Date | 2022-05-12 |