NPI | 1982364535 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 156F00000X Technician/Technologist (Licence: FL TN52013) |
Additional Taxonomies | 156F00000X Technician/Technologist (Licence: NV 65629-TCL-0) |
Enumeration Date | 2021-12-22 |
Last Update Date | 2024-11-04 |