| NPI | 1790927176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WR0006X Registered Nurse Registered Nurse First Assistant (Licence: FL 9489531) |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other Surgical Assistant (Licence: FL 07-265) |
| Enumeration Date | 2009-03-31 |
| Last Update Date | 2021-02-01 |