| NPI | 1902232366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246ZX2200X Specialist/Technologist, Other Orthopedic Assistant (Licence: AK 3336) |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other Surgical Assistant |
| Enumeration Date | 2013-09-17 |
| Last Update Date | 2016-01-12 |