NPI | 1013968437 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant Medical |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA30030) |
Enumeration Date | 2006-05-12 |
Last Update Date | 2022-03-24 |