NPI | 1003251562 |
---|---|
Former Name | IAN MICHAEL GOODSELL |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 1939) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2013-05-09 |
Last Update Date | 2022-06-24 |