| NPI | 1811196702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WX0800X Registered Nurse, Orthopedic (Licence: IN 28073597A) |
| Additional Taxonomies | 246ZS0410X Specialist/Technologist, Other, Surgical Technologist |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2015-12-18 |